According to a survey of disaster recovery decision makers, only one-in-seven businesses continuously update their disaster recovery plan. For the other businesses, the likelihood is that recovering from a disaster will be more expensive and time-consuming than planned - with some ultimately failing to recover at all.

Every few years, Disaster Recovery Journal partners up with research company Forrester Research to compile the “State of Disaster Recovery Preparedness Report”. The latest report (PDF) shows that, although more businesses have a disaster recovery plan than in previous reports, the frequency with which plans are updated and tested has fallen over the past ten years.

The failure to update and test a disaster recovery plan can have significant consequences. If elements of a business's operations have changed since the last time its plan was updated and tested, its response to a disaster may not be as effective. Depending on the nature of the event, gaps in preparedness can result in recovery being more expensive and time-consuming than anticipated.

In terms of what gaps in preparedness might cost, a report compiled by the Ponemon Institute (PDF) put the average cost of an unplanned data center outage at $8,851 per minute once direct costs, indirect costs, and opportunity costs are taken into account. More serious disasters that can't be recovered from with the click of a mouse (i.e. hurricanes and bio-terrorism) will likely cost much more.

What is a Continuously Updated Disaster Recovery Plan?

A continuously updated disaster recovery plan is one in which the business's hardware inventory and personnel database is always kept up-to-date, and details of both are integrated into the plan in real time. The plan should contain Recovery Point Objectives (RPOs) and Recovery Time Objectives (RTOs) and a priority order for software applications so that business-critical processes are restored first.

Depending on the business's tolerance for downtime, there might need to be a backup worksite for key personnel. The backup worksite needs to mirror the “everyday” worksite, so this also needs to be kept up-to-date in order to minimize the impact of a disaster. Naturally, data needs to be continuously backed up, and the plan should account for how data can be accessed during a disaster.

To overcome the potential issue of on-site data being inaccessible during a disaster, many businesses use cloud-based services to maintain an off-site copy of sensitive and business-critical data. Although it can add to the administrative overhead to maintain two disaster recovery plans in unison, this is an ideal solution for accessing data remotely and for restoring operations quickly.

Why a Continuously Used Communications System is Also Important

At the center of a continuously updated disaster recovery plan there needs to be an emergency communications system in place that is used for day-to-day communications as well as for emergencies. The reason it should be used continuously is so employees are familiar with sending and receiving messages through the system, and won´t have to deal with something “new” during a stressful event.

The system needs to be resilient against typical communication outages during a disaster (i.e. phone and email) in order to ensure key personnel and their deputies are contactable as a disaster starts, and so that all personnel are kept informed throughout an event - both on-site personnel and remote workers. The system should also support segmentation so it is easier for key personnel to prioritize messages.

For the disaster recovery communications system to be fully effective, the system should be integrated with a personnel database - particularly in a business with substantial employee churn. There also needs to be a way of monitoring message receipt so that, if key member personnel are unreachable, deputies can be quickly found to fill their roles in the execution of the disaster recovery plan.

Some organizations use a reliable mass notification system capable of sending multi-modal emergency alerts simultaneously with just three clicks on any Internet-connected device. Unlimited segmentation enables targeted, two-way communications before, during, and after an emergency; and, if your business is connected to the WebEOC system, an extension for WebEOC enables incident managers to send all emergency communications from the same platform.

The ideal mass notification system is easy to synchronize with personnel databases, plus provides the option of an SMS opt-in/opt-out capability - which is ideal for businesses receiving guests and business contacts on their premises. A user-friendly management interface enables incident managers to identify personnel who have not acknowledged an emergency alert, plus the system also supports a geotargeted poll-based alerting feature which uses polls to check on the well-being of employees in certain locations or request volunteers to cover vacant shifts. 

Assuming the Ponemon Institute's calculations are correct, gaps in preparedness could cost you more than $8,000 per minute. Communication is a key component of a disaster recovery plan; and, if you have a communications system that is not kept up-to-date or used regularly, it will likely undermine the rest of your plan.

The FBI’s recently-released “Active Shooter Incidents in the United States in 2018” report reveals that, of twenty-seven events designated active shooter incidents in 2018, sixteen occurred in businesses - the highest proportion of business-related incidents since the FBI defined it classification criteria.
According to the FBI’s criteria, there were twenty-seven active shooter incidents last year accounting for 85 deaths and 127 injuries. Naturally the incidents that received the highest profiles were the tragic events at the Marjory Stoneman Douglas High School, the Santa Fe High School, and the Tree of Life Synagogue. However, active shooter incidents at schools and houses of worship were thankfully rare.

A much higher proportion of active shooter incidents occurred in businesses -almost 60% according to the FBI ́s classification of a business shooting. This rate of business shootings is much higher than when the FBI compiled its first active shooter report covering the years 2000 to 2013, and two subsequent reports covering 2014/15 and 2016/17. Our table below illustrates this steep increase.

The Underlying Statistics are Cause for Concern

In its most recent reports, the FBI has distinguished between business shootings that occurred in environments generally open to the public (stores, malls, gas stations, etc.), and environments generally closed to pedestrian traffic (offices, factories, etc.). An analysis of this distinction reveals a slight trend of more active shooter incidents occurring in “closed” business premises.

Observable Pre-Attack Behaviors Identified by the FBI

In 2018, the FBI conducted a study assessing the pre-attack behaviors of shooters between 2000 and 2013 (PDF). The study found that only 25% of active shooter incidents were perpetrated by an individual with a diagnosed mental health issue; and, although the mental health of the individual was considered a factor, it was only one of “4 to 5” observable pre-attack behaviors.

In respect of closed-environment business shootings, the FBI identified eleven of twenty-four active shooters who were employed at the business where they committed their offenses had suffered a noticeable deterioration of their work performance. In ten of the cases studied, there had been an “adverse employment action” (i.e. disciplinary action or firing) before the event. Other factors included:

• Deterioration of interpersonal interactions
• The leakage of violent intent
• Quality of thinking or communication suffers
• Anger and physical aggression
• Deterioration of physical health
• Increased drug or alcohol abuse

The Reluctance to Report Co-Workers is an Issue

In the workplace, employees are often reluctant to report their co-workers. The 2018 Global Business Ethics Report (registration required) claimed reporting rates for “interpersonal misconduct” ranged between 30% (sexual misconduct) and 36% (discrimination). The report supports previous studies showing a reluctance to report co-workers for a range of topics from fraud to physical abuse.

The reasons why employees are reluctant to report co-workers vary from fear of retaliation, to concerns they will be regarded as the office snitch, to the belief management won´t take any action against the offender. These reasons are often justified. The Global Business Ethics Report claims 40% of employees experience retaliation after reporting misconduct, while HR Magazine reported last year that only half of reports concerning racial discrimination are dealt with effectively.

Solutions for Businesses to Prevent Active Shooter Events

It is very difficult for businesses to prevent active shooter events in environments open to the public - although solutions such as Rave Panic Button and Rave Alert can accelerate emergency response and provide timely warnings for employees in order to mitigate the impact of an active shooter incident.  However, for closed-environment businesses, a solution such as Rave Eyewitness can help prevent active shooter events by empowering employees to report pre-attack behaviors anonymously.

Anonymous tip texting services have proven to be successful when used by law enforcement agencies and university campuses, and they could be equally as successful in preventing active shooter incidents in closed-environment businesses. Employees simply send an anonymized SMS message to HR and, through the Rave Eyewitness dashboard, HR can identify developing trends and intervene to address the issues causing concern - whether they relate to pre-attack behaviors or any other type of misconduct.

Because tips are anonymized, the employee sending the tip cannot be identified and retaliated against. This will encourage further employees to submit tips when they observe pre-attack behavior, which in turn will help HR identify trends faster and act more swiftly. Furthermore, because anonymous texts are recorded in the Rave Eyewitness database, there is a level of accountability to increase employee confidence their tips will be acted on.

Find Out More about Anonymous Tip Texting from Rave Mobile Safety

No matter what criteria is used to produce the statistics, 2018 was a horrific year for active shooter incidents. In relation to closed-environment business shootings, fourteen people lost their lives and seventeen were seriously injured - deaths and injuries that could have been avoided if the perpetrators´ pre-attack behavior had been recognized, reported, and acted on.

Businesses have a duty of care to provide employees with a safe working environment in which measures are taken to reduce preventable risks to the minimum possible. Certainly the implementation of an anonymous tip texting service such as Rave Eyewitness can help minimize the risk of a closed-environment business shooting and the financial losses attributable to active shooter incidents.

To find out more about mitigating the risks of closed-environment active shooter incidents, do not hesitate to get in touch. Our team of security experts will be happy to answer your questions and explain how our solutions for businesses to prevent active shooter events work. They will also be able to organize a free demonstration of Rave Eyewitness in action tailored to your specific requirements.

Many corporate safety plans are “isolated” inasmuch as they deal with how organizations will respond individually in an emergency. However, when adopting components of the National Incident Command System, organizations can benefit from a unified, multi-agency response to an emergency.

Most organizations are required to have corporate safety plans under OSHA §1910.38. The plans should include specific procedures for how the organization will react in reasonably-anticipated workplace emergencies and assign responsibilities in areas such as communication, response management, disaster recovery, and business continuity.

Because individual organizations usually develop their own individual corporate safety plans, there is often no collaboration with other organizations or agencies. This can lead to the lack of an orderly, systematic response in the event of a widespread regional emergency such as a natural disaster or the outbreak of a contagious disease.

The Birth of the National Incident Command System

This was the situation facing fire departments in Arizona in the 1970s following a series of catastrophic wildfires throughout Arizona and California. The wildfires were responsible for considerable property damage and loss of life, and investigators found response problems were attributable to deficiencies in communication and management, rather than a lack of resources or the appropriate firefighting tactics.

The state's emergency managers determined that the regional fire departments' unique management structures did not scale effectively to deliver a unified, multi-agency response to regional emergencies. They subsequently developed the Incident Command System to provide a consistent, integrated framework for the management of all types of emergencies from traffic accidents to hostage crises.

The framework was adopted nationally and became the model for command structures at fires, crimes scenes, and other major incidents around the country - and internationally. It remained the national emergency management model until the establishment of the Department for Homeland Security in 2002 and the development of the National Incident Management System (NIMS).

Incident Command System Integrated into NIMS

The role of developing NIMS fell to the Federal Emergency Management Agency (FEMA) and, due to the proven effectiveness of the Incident Command System, its key components were integrated into the new system. All state-funded agencies are now required to follow NIMS protocols, and the scope of NIMS has been extended to include private-sector organizations who wish to join the system voluntarily.

The benefits for a private-sector organization of joining NIMS voluntarily include a unified approach to incident management, a standard command and emergency management structure, and a shared emphasis on emergency preparedness, mutual aid, and resource management. These benefits will certainly enhance communication, response management, disaster recovery, and business continuity during and after a widespread regional disaster, but they can also apply during smaller incidents as well.

Furthermore, FEMA helps private-sector organizations meet the criteria to become NIMS-compliant (see “The Fourteen Components of the Incident Command System” below). The agency provides training, personnel qualification and equipment certification, and help with resource management and technology support. These are all further benefits of joining NIMS voluntarily - particularly if your organization operates in a hazardous industry such as the energy, chemical, or waste industries.

The Fourteen Components of the Incident Command System

In order to voluntary join NIMS, a private-sector organization must comply with the “Private Sector NIMS Implementation Activities” - a revised version of the fourteen components of the Incident Command System divided into seven sections. Even if organizations have no intention of voluntarily joining NIMS, it can be beneficial to adopt some of the components in their corporate safety plans.

Section 1 - NIMS Adoption

1. When the organization has chosen to join NIMS, it is very important to ensure everyone is on board. FEMA recommends bringing in corporate leaders, trade associations, and incident management teams in the decision-making process, but it is very important to include the IT department as well.

2. Once the decision to join NIMS has been made, your organization´s key points of contact should be shared with the local emergency management authority. It is important contact details are kept up-to-date, so a system needs to be put in place to synchronize key personnel changes when they occur.

Section 2 - Command and Management

3. When an incident occurs that requires an emergency response (fire, medical, police, etc.), FEMA recommends the organization manages the incident using the Incident Command System organizational structure (PDF), and NIMS-approved Incident Action Planning and Common Communication Plan.

4. FEMA also recommends organizations also use an integrated Multi-Agency Coordination System (see the section about “WebEOC” below) to support a connectivity capability between local Incident Command Posts, 9-1-1 PSAPs, and local, state, and federal Emergency Operations Centers (EOCs).

5. In addition, FEMA recommends each organization has its own public information system. During an emergency incident, it may be necessary to alert the public to the risk of danger; so establishing communication channels with the media and other private sector partners in advance is advised.

Section 3 - Preparedness Planning

6. Organizations should revise existing corporate safety plans in order to incorporate NIMS components, principles and policies such as planning, training, response, exercises, equipment, evaluation and corrective actions. The revised corporate safety plan should be shared throughout the organization.

7. If your organization has its own firefighters, security team, or medical team, FEMA recommends exchanging memorandums of understanding with government agencies and other private-sector organizations to promote mutual aid - i.e. we'll help you when you're in trouble. In return, you help us.

Section 4 - Preparedness Training

8. NIMS consists of a core set of doctrines, concepts, principles, terminology, and organizational processes to enable effective, efficient, and collaborative incident management. To help organizations comply with these protocols, FEMA offers a range of training courses for personnel at all levels.

Section 5 - Preparedness Exercises

9. FEMA recommends trained personnel should participate in state, territory, regional, tribal and/or local NIMS-based preparedness exercises to develop experience in realistic multi-agency, multi-discipline and multi-jurisdictional exercises designed to improve integration and interoperability.

10. Organizations should use these experiences to develop their own NIMS-based exercise program specific to the organizational structure. This will give the organization the opportunity to test compliance with components 1 to 5 above and components 12 to 14 below.

11. From these internal preparedness exercises, organizations should be able to identify weaknesses in their emergency preparedness in order to apply corrective actions in subsequent preparedness exercises. There may also be correction observations passed down from local NIMS-based exercises.

Section 6 - Resource Management

12. With regards to the organization's own response assets, these should be recorded in the format described on FEMA's NIMS Mutual Aid Guidelines (PDF). The inventory should be shared with the local emergency management authority and any organizations with which there are mutual aid agreements.

13. The organization should coordinate training with mutual aid organizations to exercise their response asset inventory, and also the inventories of their mutual aid partners. This will also provide mutual aid partners with the opportunity to exercise their communication and information management.

Section 7 - Communication and Information Management

14. The final component of the National Incident Command System is to adopt a standardized and consistent terminology throughout the organization and use plain language communications to ensure accessibility and interoperability, and to avoid miscommunication during an emergency.

WebEOC Brings Together Multiple Agencies and Organizations

The WebEOC platform (Web Emergency Operations Center) was launched in 1998 as a user-friendly, web-based incident management system for businesses. The platform was adopted by FEMA in 2011 as its crisis management system to support emergency management at all levels from local to federal. As such it is the agency's preferred Multi-Agency Coordination System mentioned in Component 4 above.

As all state-funded agencies are required to follow NIMS protocols, they all choose to use the WebEOC platform. This means that every emergency service, emergency management agency, and private-sector organization connected to the platform is sharing information and resources, and working together in a collaborative manner in order to resolve emergency incidents as quickly and efficiently as possible.

From the perspective of a private-sector organization, when an emergency incident is elevated to the local emergency management authority (via the Incident Command System organizational structure), the authority creates an incident on the WebEOC platform. The platform notifies relevant state agencies and NIMS-approved organizations so a fast response can be organized.

As the emergency develops, the platform is used to share information, increase situational awareness, and coordinate responses. Resource requests can be sent from the field via any Internet-connected device; and, because the local emergency management authority has uploaded each organization's response asset inventory onto WebEOC, incident managers can identify the closest available resource.

The outcome is a fast and effective service that is the best possible solution for addressing any type of emergency incident at any level. Once an emergency incident is resolved, the WebEOC platform keeps the incident open during the clean-up process so that if additional resources are required by a state agency or private organization, they have a means through which to request them.

How Organizations Can Leverage WebEOC and Mass Notification Systems

Some mass notification systems have extensions for WebEOC that supports organizations using the platform in many different ways, while simplifying internal and external communication during and after an emergency.

With regard to the Fourteen Components of the Incident Command System (in the order they appear above);

• Data is synchronized between select mass notification systems and existing HR databases, so organizations using the WebEOC extension can be assured their key personnel contact data is always up-to-date (Component 2).
• Notifications can be sent in multiple formats including the Common Alerting Protocol (CAP) to meet the NIMS interoperability requirements of the Common Communication Plan (Component 3).
• An integrated mass notification system enables system administrators to create groups of contacts according to their role, location, or other attribute. It is therefore a suitable solution to use as a public information system (Component 5).
• As select mass notification systems support two-way communication and have its own incident command dashboard, it is the ideal tool to use during internal NIMS-based exercises and for identifying weaknesses in corporate safety plans (Components 10 and 11).
• Built-in consoles allow system administrators to create notification templates in advance. We recommend this practice to avoid miscommunication during a stressful situation, and to help organizations adopt a standardized and consistent terminology (Component 14).

Several private-sector organizations have already taken advantage of mass notification extensions for WebEOC to simplify internal and external communications - not only in an emergency, but also during exercises and day-to-day operations. 

Find out more about simplifying your internal and external incident communications.

Managing safety during severe weather preparedness can be difficult for any healthcare facility, but coordinating emergency communications and response is particularly difficult for large hospitals with multiple campuses. 

In 2017, Hurricane Harvey hit South Texas, leaving residents in Houston and the surrounding area to deal with unprecedented flooding. The storm threatened infrastructure across industries and posed a major challenge to medical care centers. Texas Medical Center is the largest medical center in the world, and also also houses the largest children’s hospital and cancer treatment center, according to Time. During Hurricane Harvey, TMC managed to maintain operations and continuity of patient care.

Located in Houston, Texas Medical Center services over 10 million patients per year and is comprised of more than a dozen hospitals or medical centers, as per Time. The center briefed over 106,000 employees on an emergency plan ahead of the hurricane, but even with comprehensive safety planning, workers were still shocked by the sheer amount of water that inundated the city. The flooding made it virtually impossible to get in and out of many of the affiliated facilities, but the hospital was prepared for this eventuality and instituted a storm-time lock in policy that wouldn’t disrupt care for patients.

By taking a closer look at the practices implemented by Texas Medical Center, large hospitals can better understand what it takes to manage operations during a major storm. While preventing damage entirely may not be possible, there are key steps a large hospital can take to mitigate harm during severe weather situations.

Developing A Severe Weather Strategy For Hospitals

A key focus of hospitals during severe weather emergencies should be continuity of operations, and healthcare facilities have a responsibility to ensure patient care is not disrupted. During Hurricane Harvey, TMC instituted a “shelter-in-place” approach to hospital operations, as per Time. Staff was called in prior to the storm, and divided into shifts of working and rest. Nobody had to leave the premises, and beds were made available for employees during rest periods. The hospital chose this strategy based on lessons from prior storms - evacuation can be difficult when transporting patients with complex medical needs. If a vulnerable patient is evacuated, there is a risk of being stuck in an ambulance or mobile care unit without access to essential medical equipment or personnel.

The TMC campus also fared well during Hurricane Harvey due to infrastructure investments made after Hurricane Allison, which hit Texas in 2001. After Allison, safety managers decided to elevate the emergency generators and switching gear located at Memorial Hermann-Texas Medical Center, according to the TMC official website. The hospital also installed submarine doors, which are made of steel, to prevent flooding. During the storm, the hospital system did not lose power and was fully operational, with there was minimal water intrusion on buildings secured with the water resistant doors.

As with any emergency situation, communication was a priority. TMC needed an effective strategy to communicate internally, as over 16,000 staff members work in the hospital system. It was important for nurses, physicians, and surgeons to understand their role and responsibility during the "shelter-in-place" period. Elective surgeries and non-essential appointments were canceled to conserve resources, and administrators need to ensure that both patient and doctor were notified of schedule changes.

Doctors also took precautions with high-risk patients, such as those undergoing chemotherapy or dialysis and pregnant women due to give birth, so certain groups of were reached out to ahead of time. Patients receiving critical treatments were given the option to come into the hospital before the storm hit or find a more convenient facility to transfer care to, and were also ensured they would be able to come to the hospital after the storm passed. Women who were pregnant were checked into rooms at the Marriott Hotel next door to the hospital maternity ward. 

Leveraging Technology to Manage Severe Weather Communications

Texas Medical Center’s patient and employee safety management during Hurricane Harvey proves that managing patient and employee safety, as well as ensuring continuity of care, is possible even during an unprecedented storm. According to TMC, the three tenants of disaster response for the largest hospital in the world are reliable data for decision making, effective organization for emergency response, and powerful tools for communication.

A mass notification system is critical for emergency communications during a severe weather event, and without one, the administrators in Texas would not have been able to communicate internally or with the community at large. Safety managers approximated that over 320,000 messages were sent over the course of Hurricane Harvey, including both general safety updates and targeted messages for specific hospital units or security teams. For this reason, hospital safety administrators should ensure that their system has the ability to send unlimited messages to an unlimited number of recipients in a record amount of time.

SMS Opt-In can also be a valuable feature for managing patient care during a storm of hurricane magnitude. If a patient has been called to the hospital ahead of the storm, they can text a keyword to opt in to receiving relevant alerts while on campus. This way, they will have access to critical storm updates, as well as any changes occurring within the hospital as the storm develops. If a safety manager is looking to invest in mass notification ahead of the next disaster, it’s important to have a fast, reliable system with a range of functionality that can address all of a larger hospital’s communication needs.

When the weather starts to warm up, it’s a sign to refresh with spring cleaning. The Japanese organizing consultant and recent Netflix craze, Marie Kondo, has brought new life to spring cleaning practices. But why stop at home? Your emergency plan also needs annual upkeep to remain functional.

The Occupational Safety and Health Administration requires organizations with more than 10 people have an emergency action plan. After a plan has been in place for over a year, it should be reviewed and updated as necessary. Putting together an emergency plan initially is hard work, and an annual evaluation helps keep that work valuable and relevant. The task of reviewing your plan is less daunting when you do it annually, and these tips make it as straightforward as cleaning out your microwave.

Review the Requirements

Emergency plan requirements are different for each industry. Below are minimum emergency plan requirements that are universal:

• Communication Plan:
  • How will your team and staff quickly coordinate during an emergency?
  • Do you have a plan to inform all essential stakeholders?
  • Are you effectively reaching out to your community with the information they care most about?
  • Means of reporting incidents and emergencies to 9-1-1
• Evacuation procedures and emergency escape routes
• Procedures and protocols for your community to follow in case of emergency:
  • Accounting for all contacts after an emergency
  • Special needs and who is responsible for them
  • Name or job title of who can be contacted
• Some industries, like healthcare, require evidence that the plan has been reviewed (and updated as necessary) on an annual basis. We recommend this for every industry.

Requirement guides by industry: •Healthcare •Schools •Corporate •Government

Communications Check

Internal

If you want to inform and guide action in your community, you first need to make sure that your internal communication is up to par.

Make sure your internal communication system is simple enough for new users to easily learn. Check that employees feel confident using the system. Are there resources available for new employees learning, or long time team members that need a refresher?

For your alerts or notification systems, check that there is nothing slowing down the process. If a system requires multiple steps to trigger a notification or alert, the system becomes less effective due to the multitude of issues happening during a live emergency. If you are unsure about delays, ask your system provider.

Not everyone can be available for a face-to-face meeting during an emergency. During your spring cleaning review, check that your internal communication system provides the ability to quickly summon key stakeholders to facilitate discussion about next steps.  It is best to check for this ability ahead of time instead of realizing in the middle of an incident.

External

Is your community engaged when you notify them? Reducing alert fatigue is an ongoing battle in a world where multiple services may require external communication with residents in the community. Are members from your community unsubscribing or opting out of communications? They may be experiencing alert fatigue from getting too many non-emergency notifications, which means they could be missing out on crucial information. One way to combat this issue directly is by leveraging SMS opt-ins for specific alerts. Geographic targeting allows emergency managers to cut down on this alert fatigue, and ensures that when residents are notified, they take it seriously.

Learn More: Preventing a Communication Breakdown Whitepaper

Contact Management

No matter your type of organization, it is important to know who your emergency plan is protecting. For business, this means the name or job title of every employee. Schools need to have all staff and students on file.

Collecting resident information is one thing, but continually maintaining it and making sure that it will be accurate and accessible in an emergency is another requirement entirely. Checking and aging out old information is beyond a spring cleaning refresh, but now is the time to recognize the problem before it escalates further.

It’s great to have a lot of contact information, but that data can do more harm than good if it isn’t stored and managed properly. Missing or false information about those you protect hinders your emergency plan’s effectiveness. If you’re not feeling confident in your current contact database, there are robust platforms that can help collect traditional information, but also nontraditional information, like special needs. Who in your community requires extra attention during an emergency?

Rave Alert’s integration with Rave Prepare™ means that information is continually verified and updated with six-month freshness checks. Additionally, information is entered by residents, freeing emergency management teams of an ongoing need for manual data entry or cleanup.

Review Drills

If you haven’t already, establish command. Decide who will be in charge of planning, executing, and managing drill issues. Having clear ownership will help everyone feel more prepared for an emergency.

It is recommended to conduct exercises and drills to practice all or some elements of your emergency plan, like emergency escape routes or off-site meetup points. Those who have an active role during a drill need to know the steps to take for staying safe during an incident no matter what.

Running each practice drill in full doesn’t have to be a part of your spring cleaning, but it is a good opportunity to establish when drills will be run or preform a tabletop drill. When you do decide to run a drill, it’s important to alert local authorities, such as police and fire departments. They’ll know there isn’t an actual emergency they need to respond to, and they may be able to provide you with resources or guidance for executing a comprehensive safety drill.

Questions to ask when reviewing your drill:

• Special Needs: Are there any needs or activities of your community that are currently unaccounted for that could affect a drill? Large events, medical requirements, etc.
• Time: Is enough time accounted for your community to execute the drill? Any parts that seem rush or stalled? Opportunities to shorten response time?
• Goals: What will indicate if the drill was a success? Establish a goal, like a quick and calm evacuation, and emphasize the importance of it to your community.

For each exercise or drill, you should assess if there are areas that need to be improved. Errors illustrate where your team needs more practice, or highlights where there may be misinformation or miscommunication among your staff. Correcting these problems would be tricky to do during an actual emergency. Your future self will thank you for identifying these weak points.

More Information: Guide and Template for Safety Drills

Floor Plan Updating

Have any physical layout changes occurred at all since you last updated your emergency plan?

Often a 9-1-1 caller is not very familiar with your facility's layout, so your emergency plan should include floor plan information if it doesn’t already.

Emergencies occurring on school campuses, healthcare, and other properties present first responders with unique challenges, which can impact their ability to provide assistance. Your facilities may be difficult to access. Make a note of any locks, gates, or codes. They can be confusing to navigate once accessed.

Review your floor plans for vulnerable areas that are new or may have been overlooked when the plan was first created. Provide any information about your facilities that you want 9-1-1 and first responders to know, ahead of any emergency.

Spring Cleaning with Preparedness in Mind

As you review your community’s emergency response plan and the best solutions to fit your needs, keep these following factors in mind. They will play a major role in the success or failure of your next emergency response.

It’s great to tackle your messy closets and corners, but spring cleaning your emergency plan benefits your whole community. You don’t need to start from scratch, just make sure your plan is clean and up to date. Preparing for upcoming emergencies requires a look backward at past incidents, and now the time to determine what worked and what didn’t. Don’t wait until your emergency plan has an issue to review it. Annually checking for any dust or cracks in your plan will help the rest of your year run smoothly.

If you’d like any assistance reviewing your current emergency plan, please reach out and we’d be happy to help!

Across the United States, nurse staffing shortages are putting a strain on hospital workers and jeopardizing patient safety. In April, 10,000 nurses threatened to walk off the job at New York’s three largest hospital systems to push for rules setting minimum staff ratios, according to the New York Times. The union representing the nurses was able to reach a deal with hospital administrators that led to the hiring of 1,450 new nurses and establish minimum ratios, but the potential strike symbolized rising tensions in the medical field.

Nurse staffing shortages must be addressed to prevent worker burnout, which compromises both employee and patient safety. There is a proven correlation between staffing and patient outcomes across quality, safety, and experience, according to the National Institutes of Health. However, the ideal nurse-to-patient ratio is unclear, given that nurses in each hospital will come from a different background as far as education, experience and training. It’s equally difficult to craft a one-size-fits all approach when each hospital or healthcare facility meets unique patient needs. For this reason, addressing nurse staffing issues requires an individualized approach. 

There are many ways that hospitals and nurses can collaborate to fix staffing concerns.  Leveraging technology can play a big role in crafting a comprehensive safety plan that both parties agree upon. Among the many technological developments in healthcare, artificial intelligence is likely to play an increasingly large role in hospital safety operations.

For the last decade, staffing shortages have impacted hospital and healthcare facility business operations, especially during emergency events. A creative approach is overdue, and artificial intelligence might have a have a part in ensuring the continuity of patient care and security.

What Are AI Integrations In Healthcare?

AI integrations are being developed in the healthcare field largely to find fast and accurate diagnoses of preventable conditions; however, it's not the only benefit of the technology. There are many more ways in which deep learning is being integrated throughout the industry, with benefits potentially being realized in surgical procedures, nursing, dosage error reduction, and the accelerated development of new treatments. Furthermore, rather than computerize the healthcare industry, AI in healthcare should give healthcare providers more time to interact with patients.

Beyond care, AI in healthcare is anticipated to reduce insurance fraud, provide administrative workflow assistance, improve supply chain management, and enhance the efficiency of finance, IT, and HR. It’s not difficult to see why healthcare organizations are keen to press ahead with AI-powered services. It has been forecasted that within ten years, AI has the potential to improve healthcare outcomes by 30 to 40 percent while simultaneously cutting treatment and operational costs in half.

Machine learning is a subset of artificial intelligence based mathematical algorithms, automating the building of analytical models that use algorithms to learn from data, as per HealthcareIT Outcomes. The machine learns from its own mistakes, and ultimately produces reliable, repeatable decisions. This technology is being successfully implemented in healthcare to analyze incoming patient vitals and referencing it against patient data to predict negative health events, such as hospital re-admissions or emergency room visits.

One of the largest obstacles to incorporating AI into healthcare will be skepticism on behalf of the patients and workers. However, applications for predictive analytics and other similar technology do not necessarily have to involve hands-on patient care, and instead can shape management strategy. This way, with nurse and physician staffing shortages throughout the industry, safety managers can ensure resources available are utilized in the best way possible to prevent burn-out and maintain quality of care.

How Can AI Integrations Improve Nurse Staffing Shortages?

AI Integrations can help address nurse staffing concerns in several key ways. AI has the potential to help nurses with documentation, cutting down on the amount of time completing bureaucratic tasks and allowing nurses to focus on patients. This will prove especially useful when it comes to compiling patient data for health files. Smart algorithms and AI could reduce the need for information to be entered manually and could link content, so that further workflows and tasks could be automatically initiated at the right time.

The AI software can also shape a nurse workflow ecosystem, reducing the need for content to be entered manually and tasks can be initiated automatically, according to HealthcareIT. The software will recognize patterns automatically, evaluate the nurse’s planned goals, and make necessary adaptations. This will cut down on time wasted for employees, and make sure that patients are receiving the most appropriate treatments.

There is also evidence that artificial intelligence reduces hospital admissions. Research suggests that machine learning can help hospitals and healthcare facilities improve intake predictions and prevent overdiagnosis. Implementing these systems could help care workers prevent more than 10% of hospital readmissions.

Not only would this be a positive for the patients, who could spend less unnecessary time in hospitals, it can also potentially help nurses prioritize their time based on the severity of the patient’s illness or injury. Reliable data would ultimately reduce staffing burdens, as nurses would have a better understanding of how to utilize their time while on call without jeopardizing anyone’s safety. 

Leveraging Technology To Address Staffing Concerns

Artificial Intelligence is not the only technology that can  reduce staffing burden by streamlining operations. Healthcare personnel can leverage technology to better communicate internally, employee absences can be more easily managed and on-call nurses can be better prepared for the shift. A mass notification system is an essential tool for healthcare facilities that allows nurses and other staff to communicate through SMS text, email, and voice calls.

A polling module feature within a mass notification system can also help address nurse staffing issues.  If a nurse manager is spending valuable time scrambling to fill a last-minute callout or resolve ongoing understaffing, it can potentially disrupt daily operations and take away from patient care. The automated poll empowers nursing supervisors and other management personnel to solicit information from a select group of nurses and other staff.  

Healthcare personnel can use the polling module to fill a staffing shortage quickly by sending out a quota poll to nursing personnel that automatically concludes after a certain amount of required responses are reached. An automated message follows informing respondents what steps to take next, as well as that the poll closed. The automated poll collects basic text-based responses, which can be organized into reports that allow healthcare organizations to make informed staffing decisions.

In August of 2017, Hurricane Harvey dropped more than 60 inches of rain on the Houston Ship Channel in Texas. The flat coastal plain is home to many of the barges, oil tankers, pipelines, storage tanks, and refineries that make up the petrochemical industry in the state. The devastating storm and subsequent flooding resulted in 8 million pounds of extra air pollution, according to NPR. Pollution was also released into waterways, and the chemicals stored at a company north of Houston caught fire. The crisis forced petrochemical plants to reassess disaster response, especially how potential public health risks are communicated with the surrounding community.

Tropical storms in the Gulf Coast are increasing in frequency and severity, and taking stock of the damage from Hurricane Harvey has potential value for the petrochemical industry. The new normal under a weather system impacted by climate change means that future storms could bring even greater damage, and facilities must be prepared for worst-case scenarios. Plant locations are often selected based on access to waterways, but as storms grow in severity and flood plains are redrawn, it’s increasingly important that these facilities are not built in susceptible areas. The chemical industry can minimize damage and health risks by avoiding building vulnerable structures in areas prone to flooding or with high-population density.

However, structures across the Gulf region, and in other areas of the country, will become increasingly susceptible to natural disaster, even while complying to safety standards. Amid record-breaking storms, it’s difficult to predict the force and speed with which a hurricane can descend on a region of the United States. For this reason, petrochemical companies should prepare for the  worst-case scenario, and to communicate any critical damage to the community.

Building A Comprehensive Disaster Response Plan

Hurricane Harvey made landfall faster than previous storms, which presented unique safety challenges. In fact, the unpredictable nature of hurricanes and tropical storms should be reason enough for petroleum plant managers to reassess safety plans after each severe weather emergency. Each hurricane can bring different conditions - Hurricane Harvey was characterized by major flooding and levee damage, for example, but during storms, high-wind speeds and power outages can be a top concern. Annual reassessment should be part of any comprehensive disaster response plan, and it’s been shown to help petroleum manufacturers minimize damage.

The chemical company Covestro in Baytown, Texas, was able to prevent additional pollution as a result of Harvey largely because the of the safety lessons learned after Hurricane Ike in 2008, according to NPR. After Ike, Covestro moved critical servers and computers away from the bayou and into a building on higher ground. This way, even though the plant was flooded during Hurricane Harvey, the team was able to monitor and communicate what was going on. Covestro resumed operations less than two weeks after the storm.

Rod Herrick, who manages safety operations for Covestro, offered several other suggestions for storm preparedness. Several of these recommendations involve physical planning. Moving generators to higher ground is essential amid record floods, and companies can prevent water contamination by installing containers under tanks to manage leaks. There are also geodesic domes, which prevent the weight of rainwater from causing leaks in the top of tanks companies use to store hazardous materials. Herrick also recommended small actions employers can take to prevent disaster during a hurricane, such as stocking up on cleaning supplies and such as mops or brooms to sanitary products for employees. These are small things that ultimately add up to

Communication is key for managing an emergency such as a storm - both for internal operations and external communications. According to Bloomberg Environment, the KMCO petrochemical plant began preparations a week before Hurricane Harvey made landfall. As the storm approached, the company established a checkpoint system, secured the plant, and made sure the backup generator was equipped to support the plant for several days. Only essential employees were told to report to work, with a handful of operators, mechanics, and electricians remained on call during the height of the storm.

Effective communications can help a petrochemical plant prevent major leaks or other complications, however, these facilities should also prepare emergency communications for the worst-case scenario. During Hurricane Harvey, Arkema underestimated the damage from flooding, resulting in a series of explosions around the plant, as per Bloomberg environment. Company officials realized that the backup generator had failed, and that evacuating residents within a 1.5 mile radius would be necessary.

Communicating the disaster is essential during a high-risk emergency of this sort, and petrochemical companies must keep both employees and the surrounding community safe. 

Leveraging Technology to Improve Community Safety

A mass notification system can be an essential tool for managing a petrochemical-related disaster during a storm. If residents are already receiving weather-related alerts, it’s important the local safety managers are providing updates as the storm develop. In a situation such as the Arkema fires, residents must be given an evacuation notice as quickly as possible. If the plant understands there is risk of fire, explosion, or other systematic malfunctions, evacuations should be considered in advance. If a plant has a comprehensive safety plan and risk is low, the safety managers can also use mass notification to assure the community that emergency procedures are in place during the storm.  

The notification system can also be used to communicate internally. If only key personnel are going to be required during the storm, the petrochemical plant can communicate staffing changes to employees. This way, nobody nonessential will be on site or put in a situation where safety can be jeopardized.

The Christchurch mosque shootings on March 15 shook New Zealand and prompted a powerful inquiry into the worst mass murder in the country’s history. The shootings were two consecutive terrorist attacks in Christchurch, New Zealand during Friday prayer. The first attack was live streamed on Facebook. The Australian gunman, a white supremacist, has been charged with 50 murders and 39 attempted murders.Reminders of loss are never far away from these families, whether it be an empty seat at the dinner table or Ramadan. The losses have sparked conversations around the globe about law enforcement, safety technology and more.

Christchurch First Responders

According to the New York Times, officers apprehended the suspect only 36 minutes after receiving the first emergency call. The police said they received the first call for help at 1:41 p.m., when mosques were packed for Friday prayer. 

Forty-two people were killed during the six minute attack at the Al Noor Mosque. At 1:48 p.m., the suspect gets back in his car and drives towards his second target. Three minutes later, a siren can be heard on the video footage as he is driving to the second mosque. The gunman was gone by the time police arrived.

The police said a special armed tactical unit arrived at Al Noor four minutes after the first officers, or ten minutes after the initial emergency call. Still, it was not fast enough. The officers arrived to a horrific scene, with the dead and wounded outnumbering the city’s usual on-duty police force.

The gunman then attacked the Linwood Mosque, almost four miles east of Al Noor. The second mosque caused confusion for call centers. “Calls coming in from one, and then calls saying a second mosque, and people saying, ‘What? Do you mean this mosque or that one?’” said Chris Cahill, a detective inspector who is president of a local labor union for police officers.

Lateef Alabi, the imam leading prayers at Linwood, heard a voice outside at about 1:55 pm. He saw the gunman and two bodies on the ground out the window, and warned the congregation of about 80 people to get down. Abdul Aziz, who had been praying with his four sons at the time, bravely flung a handheld credit card machine at the attacker. Officers arrived at the mosque soon afterward, he and other survivors said. Witnesses credit Aziz's bravery for slowing down the shooter until officers could intervene. 

Authorities barricaded streets in an attempt to place the area on lockdown and search for the gunman. Police urged Christchurch residents to stay indoors and monitor the police website and social media. Local schools were placed on lockdown when police ordered students to not leave their classrooms between 2:20 pm and 6 pm that day. Desperate parents were unable to reach their children following the attacks. Some teachers were confronted by irate parents demanding their children be allowed to leave. Students were kept safe, but the incident brought to light issues with the school's current safety protocols. School lockdown procedures will be reviewed urgently in New Zealand to improve communication.  "One of the things that we've been told that when we go into lockdown what we must do ... is to shut the school off from the wider community, but the communication between the two is the critical factor." says Burnside High School principal Phil Holstein according to Radio New Zealand. 

“It absolutely was his intention to continue with his attack,” said Prime Minister Jacinda Ardern after the arrest of the shooter, a former personal trainer from Australia who distributed a manifesto of white extremist hatred minutes before the rampage. 

"We strongly believe we stopped him on the way to further attack," said police commissioner Mike Bush. He told reporters that the gunman was en route to terrorize more people before officers intervened. The New Zealand Herald reports that police officers had just attended a training session on how to deal with armed offenders when they dragged the gunman from his car following the shootings.

Prime Minister Jacinda Ardern paid tribute to the emergency workers who were first on the scene of the Christchurch attack. "I have no doubt that you saved lives... thank you for doing what you do... on our darkest, darkest hours and our darkest days," she told them as she visited the Justice and Emergency Services precinct. The prime minister and the first responders later had a private meeting, during which the emergency workers were expected to brief her on their experiences. 

Social Media Involvement

The shooter strapped a camera to his forehead to stream a live video on Facebook as he gunned down dozens of people who had gathered to pray. He teased his act on Twitter, announced it on the online message board 8chan and appeared to have posted a 74-page manifesto online. The video was mirrored around the world before the major tech companies could even react. The shooter left an internet breadcrumb trail leading up to the mass murder designed to maximize attention.

On March 27, representatives from four social media companies gathered with members and staff of the House Homeland Security Committee for a briefing. The focus: how the Global Internet Forum to Counter Terrorism—an industry group composed of Facebook, Twitter, Google, and Microsoft—had responded to the New Zealand shooting.

The shooter live-streamed the massacres for an hour, until New Zealand law enforcement asked the company to take it down. Facebook users had already re-uploaded the video of the murders on to the platform hundreds of thousands of times. The company said it removed about 1.5 million videos of the mass shooting in the first day after the shooting. And those are just the clips they were able to catch.

Two years ago, Facebook rolled out a counter-terror algorithm meant to block gruesome or inappropriate content from being posted on the site. The algorithm failed to block the live stream from the mosque on March 15. Congress met with Brian Fishman, Facebook’s policy director for counterterrorism, to discuss. The briefing was closed door, but according to The Daily Beast, Fishman said there was “not enough gore” in the video for the algorithm to catch it.

There is pushback against Fisherman’s defense. Facebook’s technology and filters have rapidly pulled down videos featuring copyrighted music and advertisements that criticize the platform. Although social media companies have made significant progress using machine learning to identify inappropriate or disturbing content, there is a long way to go.

Facebook has put up a blog to address the criticisms and explain how this happened:

"[Artificial Intelligent] systems are based on ‘training data’, which means you need many thousands of examples of content in order to train a system that can detect certain types of text, imagery or video.” The blog explains that this has worked for nudity, propaganda and graphic violence because there are large number of examples to better train the systems. “However, this particular video did not trigger our automatic detection systems. To achieve that we will need to provide our systems with large volumes of data of this specific kind of content, something which is difficult as these events are thankfully rare.”

Bad communities also worked together to continually re-upload edited versions of the video in ways designed to defeat Facebook’s detection. Six people appeared in a New Zealand court on April 15 on charges that they illegally redistributed the gory video.

Another challenge is discerning content that is visually similar but innocuous, like video game footage - “for example if thousands of videos from live-streamed video games are flagged by our systems, our reviewers could miss the important real-world videos where we could alert first responders to get help on the ground.”

Facebook hopes that their content moderators and flagging systems could someday help first responders in real-time. In November 2018, Facebook announced that more than 100 local governments and first responders with Facebook Pages are testing "local alerts." There has not been an update on how the test is going yet. As much as social media can do in 2019, it is far from being a safety solution.

In March of 2019, unionized nurses in New York City delivered a formal strike notice to the three largest hospital networks. The notice warned that if the hospital management and the New York State Nurses Union didn’t reach an agreement, 10,000 nurses would not show up to work and picket outside of Montefiore, Mount Sinai, and New-York Presbyterian hospitals, as per Vice. 

The New York State Nurses Association ultimately managed to negotiate with the New York Hospital Alliance on the issue of staffing, and the strike was withdrawn. Insufficient staffing ratios are causing tension in the nursing field across the United States, and hospital safety managers should prevent and prepare for picketing or strikes.

Nurse-to-patient ratios have dominated conversations about healthcare safety. Professionals working in healthcare are statistically more likely to face instances of workplace violence than other industries. In 2016, researchers found that nearly 75% of all workplace assaults occur in healthcare. Many hospitals and healthcare facilities are underfunded and face staffing shortages, which creates even more risk in the workplace. California was the first state with laws that require a required minimum nurse to patient ratio per hospital unit, and it remains the only one to create a mandate on the legal level. Massachusetts is the only other state with a similar law, requiring a 1:1 or 1:2 nurse to patient ratio in the ICU.

In 2018, the Bureau of Labor Statistics reported that education and healthcare workers were most likely to go on strike. In January, Los Angeles public teachers organized a weeklong strike to protest current working conditions and advocate for for capsizes in classrooms, full-time nurses and librarians in schools. The strike impacted classrooms across the state for half a million students in the state, but teachers were able to negotiate with the state for their conditions. Administrators could have avoided the disruption by coming to the table sooner, and the strike could be just the first from unions in similar workplaces. 

Staffing is an issue that is becoming increasingly contentious in hospitals and healthcare facilities across the United States. In 2018, nurses in hospitals run HCA, one of the countries largest healthcare providers, picketed and threatened to strike in five states, according to the New York Times. Hundreds of nurses staged a walk-out in Vermont to call attention to staffing issues earlier in the year as well. These strikes can disrupt hospital or facility operations, if not halt them entirely. 

How To Prioritize Safety During A Nursing Strike

Putting together a long-term, a sustainable safety plan is the goal of any hospital or healthcare facility. Patient-to-nurse ratios should be a consideration as part of comprehensive healthcare security, and hospital managers should work with employees to find ways to reduce the burden on doctors and nurses. If these issues are left unaddressed, it creates an increasing strain on nursing teams and compromises patient safety. The notice and picketing in New York suggests that nursing unions will continue to use strikes to advocate for patient-to-nurse limits if concerns are unheard, and hospital safety managers can prevent that eventuality by creating a dialogue with nurses.

Hospitals have a responsibility to supply patients with uninterrupted healthcare, even should a strike occur. Transparency is key during a nursing strike, so if changes in treatment are inevitable, this must be communicated to patients. Make sure that parents are informed of changes in staffing, whether this is care from nurses or doctors. Patients will appreciate the autonomy to make informed decisions amid staffing disruptions. If a patient is better served at a different healthcare facility during the strike, hospitals should coordinate a transfer of care. Preparing EMS or ambulance teams ahead of the strike will help avoid further inconvenience for patients and workers. 

The number one thing hospitals can do to avoid compromising patient safety is address nursing concerns before a labor strike occurs. If a nursing union is calling for the health care system to hire more nurses amid staffing shortages, it is a signal to administration that patient safety might be jeopardized. Walk-outs and strikes are often a last resort for nurses - they don’t want to disrupt patient care or hospital operations as much as hospital administrations don't. These situations occur when communication does not occur. A comprehensive safety plan benefits all hospital workers, and if hospital administration collaborates with nurses on procedural matters, there will be fewer issues in the long term.

Leveraging Technology To Reduce Nursing Burden

Technology can be a powerful tool for maintaining hospital operations during a nurse strike, and a mass notification system can help tackle communication challenges. Notifying doctors, surgeons, and staff that personnel will be missing during the period of the strike is essential for both worker and patient safety. The ecosystem of every hospital department depends on nurse coverage, and it’s critical that any changes in staffing be communicated.

Some mass notification systems also have an automated polling module that allows nursing supervisors and other management personnel to solicit information from a select group of nurses and other staff through SMS text, email and voice calls and send automated follow-up notifications based on their responses. Healthcare personnel can use the polling module to fill a staffing shortage quickly by sending out a quota poll to nursing personnel that automatically concludes after a certain amount of required responses are reached. 

A mass notification system can also keep the community informed if a strike or picket will disrupt hospital hours. The planned picketing around the three main hospitals in New York City would have had the potential to disrupt commutes and other foot traffic, which can create greater safety risks. Changes in hospital traffic should be communicated to residents, and keeping all informed will prevent further chaos or disorganization in the neighborhood. 

The mass notification system can also help reduce burden of nurse to patient ratios in the long term. This tool can enable RN and department managers to make sure nurses are serving patients within their area of expertise and speed up communication between nursing teams. The facility can reduce time spent on bureaucracy and communication, and ensure that every patient is receiving the best possible care without putting a major strain on staff. This can help the hospital take full advantage of personnel and resources, which helps reduce the burden on nurses who are already overworked. 

CMS Hospital Star Ratings are a quick-reference guide to the performance metrics of more than 4,500 hospitals nationwide. Because of the way in which they are calculated, users of the Hospital Compare web portal are advised to do their own due diligence before relying on the CMS ratings to make a treatment decision, which could have implications for hospital leaders.

The Centers for Medicare and Medicaid Services (CMS) is a federal agency within the Department for Health and Human Services. One of the agency's goals is to improve the healthcare system in the United States by enhancing the quality of care provided to patients. To help achieve this goal, the agency created the Hospital Compare web portal in 2002 to provide information to healthcare consumers about how qualifying Medicare and Medicaid hospitals compare against each other.

What started out as a basic comparison site covering only inpatient care has evolved over the years. Consumer Assessments and Outpatient Quality Reporting were added in 2003 and 2008 respectively; and subsequent additions to the Hospital Compare web portal include a Readmissions Reduction Program and a Hospital-Acquired Conditions Reduction Program. Although star ratings were already in existence for specific medical disciplines, CMS Hospital Star Ratings were introduced in 2016.

How CMS' Hospital Star Ratings Work

Hospitals are required by law to report inpatient performance metrics to CMS, and are “incentivized” (*) to report outpatient performance metrics each year. Data are divided into seven categories, and the hospitals' performances in each category are weighted to give an overall Star Rating. In addition, data from each category are compared to the national average of each category, and a score of “above”, “same as”, or below” the national average is awarded to each hospital. The seven categories are:

• Mortality Rate (Weighted average of overall rating - 22%)
• Safety of Care i.e. hospital acquired conditions (22%)
• Unplanned Readmissions (22%)
• Patient Experience Surveys (22%)
• Effectiveness of Care (4%)
• Timeliness of Care (4%)
• Efficient Use of Medical Imaging (4%)

So as not to exclude small or specialized hospitals - or those unable to provide a full data set due to their unique characteristics - hospitals only have to report data in at least three of the seven categories including at least one of the “outcome” categories (Mortality Rate, Safety of Care, or Unplanned Readmissions) in order to qualify for a Hospital Star Rating. Each category has between five and eleven fields, and at least three fields must be completed in each.

When hospitals are unable to complete the required number of fields in all seven categories, the weighting is redistributed. For example, a specialist pediatric hospital would be unable to report performance metrics for Mortality Rates and Unplanned Readmissions as the fields in these categories relate to non-pediatric events. Consequently the percentage weightings for Safety of Care and Patient Experience Surveys would increase to 39.285%, while the other weightings would increase to 7.1433%.

(*) Hospitals that fail to report outpatient data can have the following year´s Medicare payment reduced by 2%.

CMS' Hospital Star Ratings for 2019

The most recent Hospital Star Ratings were published in January 2019. Of the 4,573 hospitals that submitted performance metrics, only 293 achieved the full five-star CMS' Hospital Star Rating. Although this represents just 6.41% of all qualifying Medicare and Medicaid hospitals, it was a slight increase in number from the previous Hospital Star Ratings in December 2017 due to a chance in methodology. There were also increases in the number of hospitals achieving four stars and three stars.

Criticisms of CMS' Hospital Star Ratings

The primary criticism of CMS' Hospital Star Ratings is that hospitals can manipulate their overall scores by selective reporting performance data where the opportunity exists. An analysis of the data reveals, of the hospitals that achieved a five-star rating, thirty reported data in the minimum three categories, and only one of these achieve an “above national average” in all three categories. Conversely, it is claimed hospitals that file comprehensive performance metrics appear to be penalized for their honesty.

That's not necessarily the case as a high rating could be achieved due to the nature of the hospital's services. If you take the example of the pediatric hospital mentioned above, nearly 80% of the hospital's rating would be calculated on factors such as surgical site infections (relatively rare in a pediatric setting) and patient experience surveys (relatively positive in a pediatric setting). It would also be hard to fault the hospital's Effectiveness of Care, Timeliness of Care, or Efficient Use of Medical Imaging.

Due to the criticisms of the Hospital Star Ratings system, CMS has announced it will revise the system for the next series of star ratings and is currently accepting comments about the best way to go about making changes. Comments suggested so far include revising the categories and removing the weighting element so the Hospital Star Rating is based on average scores, and placing hospitals with similar characteristics (such as pediatric hospitals) into peer groups to facilitate more like-for-like comparisons.

Why You Shouldn't Disregard CMS Requirements Altogether

An important requirement was added to CMS rules in November 16, 2017, requiring all hospitals and healthcare institutions to have effective emergency response mechanisms and processes in place. During emergencies, a hospital mass notification system is important to quickly communicate timely information to management and
employees, obtain the status of employees, and alert employees of emergency situations. 

A recent survey found that within the last two years, 27% of healthcare organizations had encountered workplace violence incidents. The survey also revealed that hospitals and other medical facilities are using certain modes of communication more than others, yet not all of these methods are reaching their diverse communities. Find out more about healthcare emergency preparedness trends by downloading the survey report.

Statistics relating to domestic violence in the workplace are often out-of-date and generally unreliable. Nonetheless, the issue undoubtedly exists, and businesses have a legal obligation to address the impact of domestic violence on victims, as well as the financial motivation for doing so.

Most reports relating to domestic violence in the workplace rely on data produced more than ten years ago for the Bureau of Justice Statistics Workplace Violence Report 1993 - 2009 (PDF). In the report, one small section relates to the victim/offender relationship of reported crimes, and shows that women are twice as likely to suffer workplace violence perpetrated by an “intimate partner” as a man. However, if you read the small print beneath the data, both calculations are based on ten or fewer reported incidents; which - over a sixteen year period - would suggest the data is unreliable.

A more feasible estimate of the volume of domestic violence in the workplace appears in Hope Tiesman's study of workplace homicides among U.S. women and the role of intimate partner violence published by the U.S. Library of Medicine. Although drawing on an even older source of data, Ms. Tiesman estimates 13,000 acts of violence are committed each year by intimate partners against women at work; which, if the Bureau of Justice Statistics figures are to be believed, implies a further 6,500 acts of domestic violence in the workplace against men - bringing the annual total close to 20,000 cases.

Why These Statistics May Still Underestimate the Extent of the Issue

In previous blogs, we have periodically discussed the underreporting of non-fatal injuries and illnesses in the workplace and how discrepancies of up to 48% existed in California between the number of injuries reported and the number of worker's compensation claims. However, with regard to domestic violence, the situation is further complicated by perceptions of what domestic violence consists of, and the unwillingness of both employers and victims to report domestic violence in the workplace. Let's look at the first lines of three different definitions of domestic violence to start with:

From Merriam-Webster

• The inflicting of physical injury by one family or household member on another.

From the U.S. Department of Justice

• The term “domestic violence” includes felony or misdemeanor crimes of violence committed by a current or former spouse or intimate partner of the victim.

From Legal Dictionary

• An abusive, violent, coercive, forceful, or threatening act or word inflicted by one member of a family or household on another.

Note how Merriam-Webster defines domestic violence as “the inflicting of physical injury”, and the U.S. Department of Justice definition implies physical injury by including the terms “felony or misdemeanor crimes” and “violence”. Many acts of domestic violence are non-physical. Under the Legal Dictionary definition, domestic violence can include psychological, emotional, and financial acts, and even include threats of abuse. It´s no wonder domestic violence in the workplace goes underreported, because many people - in some cases the victims themselves - fail to recognize it.

An Unwillingness to Report Domestic Violence in the Workplace

An unwillingness to report domestic violence in the workplace exists at both employer and victim levels. From an HR perspective, while some employers don´t want to get involved because they perceive domestic violence as a “family matter”, others have concerns about digging into employees´ personal lives and the confidentiality issues that accompany disclosure. There is also the risk that responding in the wrong way to employees who report they are suffering from abuse may invite lawsuits - either from the victim or their abuser.

One interesting - and relatively reliable - source of data about domestic violence is the Violence against Women Report (PDF) that was published as part of the National Crime Victimization Survey conducted in 1992/3. Over 100,000 women were interviewed during the survey; and, of those who suffered domestic violence by an intimate partner, only 55% (injured) and 46% (non-injured) reported the incident to the police. When asked why they were willing to reveal the abuse to researchers, but not to law enforcement officers, the three most common reasons given were:

• The private nature of the event.
• The stigma associated with being a victim.
• The belief that reporting the abuse would not stop it.

It is important to note the Violence against Women Report covered domestic violence in all circumstances, not just in the workplace. However, building on that data, the Society for Human Resource Management conducted its own survey in 2013 and found that 19 % of (surveyed) businesses had experienced a workplace domestic violence incident in the past year. The survey also found that 65% of businesses do not have policies to deal with workplace domestic violence, or the consequences of employees who bring household domestic violence to work with them.

The Legal Obligation and Financial Motivation to Address Workplace Domestic Violence

Employers have a legal obligation to prevent all definitions of workplace domestic violence under the federal Occupational Safety and Health Act that stipulates employees should be protected from the “threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site”. State employment laws may also further enforce this rule. Therefore, inasmuch as employers may invite lawsuits for responding the wrong way to reports of abuse, they may also invite lawsuits if they fail to address workplace domestic violence at all.

Possibly more of a motivating factor for addressing workplace domestic violence is the financial cost of not addressing it. Businesses pay a price for workplace domestic violence in lower productivity and higher absenteeism, plus they may also incur medical-related costs, higher employee benefit costs, increased insurance premiums, and increased sick leave expenses. Furthermore, when a domestic violence incident occurs in the workplace, the incident disrupts the productivity of other employees. It has been estimated that the total cost per year of workplace domestic violence is $1.8 billion.

The bottom line is that it makes legal and financial sense to address domestic violence in the workplace along with any other type of workplace violence. It also makes sense to address the consequences of employees who bring household domestic violence to work with them, as these too can have an impact on productivity and the quality and quantity of work being produced by the entire workforce. Many employers will also acknowledge a moral obligation to provide the best level of care for employees.

Solutions for Addressing Domestic Violence in the Workplace

Many HR professionals advocate abuse awareness training and the implementation of policies and procedures to address domestic violence in the workplace. Although raising awareness of domestic violence is undoubtedly a good thing, especially if employers commit to reporting incidents so the scale of the issue can be accurately quantified, raising awareness in itself is not going to overcome the unwillingness of victims to come forward and seek help. For that to happen there needs to be a complementary solution that is both discrete and effective.

One of the most widely used solutions in these circumstances is an anonymous tip texting app. Abused employees can use the apps to confidentially and anonymously seek help from HR departments, while colleagues of the victim can also contact HR departments to raise concerns with complete confidentiality. Anonymous tip technology is proven to increase engagement and encourages employees to share critical information - not only about domestic violence, but also about other threats such as bullying, insider theft, and drug abuse.

In some cases, these solutions integrate seamlessly emergency notification solutions that can simultaneously warn employees about a potentially malicious partner on premises, and alert security personnel (and law enforcement if necessary) to a potential act of violence. All three solutions are quick and easy to implement, and are the best way to support policies and procedures to address domestic violence in the workplace. 

Denver Health and Hospital Authority improved its emergency notification system with a new solution, that also brought them into compliance with the CMS Emergency Preparedness Rule. The new mass notification system also proved beneficial for internal communications and departmental messaging.

The Denver Health and Hospital Authority has been treating and healing the people of Denver for more than 150 years. Denver Health sees nearly 930,000 total patient visits annually and, in addition to its 525-bed main campus, the Authority manages thirty external health centers and urgent care centers throughout the city.

As a Medicare and Medicaid provider, Denver Health is required to comply with the CMS Emergency Preparedness Rule. Under the Communications Plan core element of the Emergency Preparedness Rule, the Authority must have an effective notification system in place that alerts staff and other necessary persons when emergencies occur.

In the case of Denver Health, its database of staff and other necessary persons consists of approximately 3,700 contacts who are distributed throughout its managed properties. Not every one of them would need to be alerted to a localized incident. Indeed, it would only be necessary to send a system-wide alert in the event of a natural disaster, email server outage, or major engineering incident.

Consequently, any emergency notification system implemented to comply with the Emergency Preparedness Rule had to be capable of distinguishing groups of contacts by their role, location, or other attribute. As an additional requirement of the Authority, it also had to be capable of handling non-emergency internal communications and departmental messaging.

The Denver Health Case Story

Prior to the implementation of their healthcare mass notification system, Denver Health did have a previous system, but the Authority received feedback that some staff were not receiving notifications. Tests conducted on the system not only confirmed the non-receipt of alerts, but also identified issues with dispatch delays and administrators struggling to send alerts due to the system's design.

The Authority evaluated a number of replacements and selected a new mass notification system due to its “reliability, sending rates, and administrative capabilities”. Logan Fuller, the Authority’s application analyst, commented: “Messages...went out quite a bit faster than the application we were using. The departments that received messages were impressed that it happened right away.”

Once selected, the implementation of the new system went very smoothly. The mass notification system was integrated with the Authority's directory database so the two systems synchronized automatically, and a hierarchy of role-based permissions was created. A user portal was also created so the Authority's contacts could set their message preferences and add additional information.

Contacts on the database were sorted into groups, and administrators were able to create messaging templates to accelerate departmental messaging. Not only did the new mass notification system enable Denver Health to become compliant with the CMS Emergency Preparedness Rule by improving its Emergency Notification System, it also help the Authority better communicate internally.

Our new eBook investigates the most common types of reported workplace violence, the occupations most at risk from workplace violence, and the factors that contribute to a higher risk of violence at work. The eBook also explains why improving emergency communications is key to employee safety.

One of the biggest issues affecting employee safety is workplace violence. According to the Occupational Health & Safety Administration (OSHA), nearly 2 million American workers report having been victims of workplace violence each year; and, although the Administration acknowledges that many cases of workplace violence go unreported, 2 million injured employees may only be the tip of the iceberg.

Comparisons between OSHA injury reports and workers comp claims have revealed discrepancies of up to 48% in the number of injuries attributable to workplace violence, and a study by the American Journal of Industrial Medicine (PDF) found that 90% of surveyed businesses did not comply with OSHA's recordkeeping regulations. In theory, there could be 20 million victims of workplace violence each year.

Workplace Violence is Underreported because it is Misunderstood

Various reasons have been suggested for why workplace violence is underreported. These can vary from unfamiliarity with reporting requirements, to potential damage to the business' reputation. A more likely explanation is that both employers and employees misunderstand what constitutes workplace violence - believing that a physical injury has to be sustained before an incident is reportable.

However, OSHA's definition of workplace violence includes “any act or threat of physical violence, harassment, intimidation, or other threatening disruptive behavior that occurs at the work site.” This means threats, verbal abuse, and non-physical sexual abuse are also classified as workplace violence and should be reported by employees to employers, and by employers to OSHA.

A further issue contributing to the underreporting of workplace violence is employee reticence. In her article “7 Reasons Employees Don't Report Workplace Violence” Carol Fredrickson - a specialist in workplace conflict resolution - concluded employers need to create an effective reporting system to ensure employees felt safe and supported when reporting violence of any kind in the workplace.

The Most Common Types of Reported Workplace Violence

Due to the misconception an injury has to be sustained before violence at work is reportable, the most common types of reported workplace violence are:

Workplace Violence Attributable to Criminal Intent

This category is dominated by criminals with no connection to the workplace. Typically they enter premises or attack mobile workers (i.e. taxi drivers) with robbery as the sole motive. The vast majority of workplace homicides fall into this category.

Assault by a Customer or Client

In this category, the perpetrator has a legitimate relationship with the business and becomes violent while being served by the business. Examples of workplace violence in this category include physical assaults on police officers, teachers, and healthcare workers.

Employee-on-Employee Violence

This is likely the most underreported category of workplace violence due to the misunderstanding of what constitutes workplace violence and employee reticence to report incidents due to concerns about retaliation, becoming known as the “office snitch”, and employers' perceptions.

Personal Relationships

When domestic violence is carried into the workplace, it can place employers and employees in awkward situations. Often the employer views incidents of this nature as “problems to deal with at home”, while employees are reluctant to report them due to concerns about future prospects.

Ideological Violence at Work

This category of workplace violence is perpetrated by value-driven groups or extremists against businesses, their employees, and their properties. Formerly included in the “criminal intent” category, ideological violence has escalated in recent years and now has its own reporting category.

The Occupations Most at Risk from Workplace Violence

In all probability, the underreporting of workplace violence occurs in every industry and in every occupation. Therefore, even though the official statistics do not reveal the full extent of the problem, the distribution of reported incidents across various industries is likely to be a true reflection of the occupations most at risk from workplace violence.

However, within most occupations, some employees will be at greater risk from workplace violence than others because of their roles. Using the occupations mentioned so far as examples (taxi drivers, police, teachers, and healthcare workers) it is possible to explain this point in greater detail:

• A yellow cab driver will be at greater risk of workplace violence attributable to criminal intent than a private chauffeur.
• A police officer in an emergency response team is more likely to suffer a work-related injury than a community coordinator.
• A teacher teaching a class of inner city teenagers is at greater risk of sustaining an injury than a private tutor.
• A psychiatric nurse is more likely to suffer physical assault and verbal abuse than a nurse working in a neonatal department.

Therefore it is necessary to look at the factors that contribute to a higher risk of violence at work and to take measures that mitigate the risks. 

Contributing Factors to a Higher Risk of Violence at Work

Because workplace violence attributable to criminal intent - or due to an assault by a customer or client - are the most frequently reported incidents of violence at work, research conducted into “contributing factors” tends to consider these categories more than any other. Consequently, the most commonly recorded contributing factors to a higher risk of violence at work include:

• Working alone or in small numbers
• Working at a location with poor environmental design
• Handling money, valuables, or drugs
• Carrying out inspection or enforcement duties
• Providing a service, education, or healthcare
• Working with unstable or volatile people

Beyond the criminal intent/assault categories, working during periods of intense organizational, personal, or political change can be a significant contributing factor to violence at work. At these times, employees may be under pressure due to their roles at work, their personal life, or because they have political views that contrast strongly with those of their work colleagues.

Why Improving Emergency Communications is Key to Employee Safety

Most businesses have some form of emergency communication system, even if it is only a wall-mounted fire alarm. Many security-conscious businesses have implemented mass notification systems, while those with employees at a higher risk of violence at work have taken advantage of personal safety mobile apps to accelerate emergency responses when a workplace incident occurs.

Emergency communications can be taken one stage further by issuing employees with personal safety apps. These incorporate mass notifications and can call for emergency assistance with two taps of a Smartphone screen in the same way as a panic button app can, but the personal safety apps also include automated safety timers and anonymous tip submission capabilities.

These two features can make a significant difference to personal safety at work. The automated safety timer alerts security personnel to lone workers who have failed to “check in” by deactivating the timer, while submitting tips anonymously encourages employees to report employee-on-employee workplace violence and escalating personal relationships without fear of retaliation or other negative outcomes.

The Cost to Employers of Workplace Violence

Implementing measures to improve emergency communications - and to receive tips about escalating relationships due to organizational, personal, or political pressures - are not very expensive, and can save businesses a considerable amount of money. Estimates of how much workplace violence costs US industry vary, but have been quoted as up to $121 billion annually.

The costs are not just accounted for by lost productivity when employees take time from work to recover from their injuries. Costs can include medical and psychiatric care, repairs and clean up, higher insurance rates, increased security costs, and the loss of valued employees - not necessarily due to a physical injury, but because they find their working environment hostile.

In addition, businesses can be held liable for not making their premises safe for employees and customers. Potential areas of workplace violence-related litigation include civil actions for negligent hiring, third-party claims for damages, invasion of privacy actions, and OSHA violation charges.

A recent webinar revealed findings from our second annual survey on workplace safety and preparedness, including an increasing potential for emergency communication challenges in organizations. Over 500 full-time employees from various industries across the United States completed the 18-question survey, which uncovered interesting trends on workplace emergency plans, employees' perspective on safety and the current level of emergency communication efforts in place at workplaces today. 

Katharine Dahl, Rave's Senior Director of Product Marketing presented each of the four key findings throughout the webinar and provided detailed best practices to put into action for workplace emergency preparedness efforts.

Trend #1 Demonstrates a Shift Towards More Modern Workplace Emergencies

The original 2018 survey report found that many workplaces had a heavy emergency preparedness focus on fire drills and while the second annual survey found similar data, it showed slight improvements in awareness of more modern emergencies. 2019 data shows a growing awareness and testing of emergency plans. In comparison to 2018 data, there was a slight decrease in the number of employees who were unaware of their workplace's emergency plans for more modern situations such as active shooters. 

Katharine highlighted a startling fact from the National Safety Council that more than 2 million American workers report they were victims of a workplace violence incident and that many more cases go unreported. Although more workplaces are starting to increase their preparedness efforts around situations such as active shooter events, Katharine pointed out that workplaces should also consider workplace violence as another major incident to prepare for and offered a best practice to help with emergency preparedness efforts. 

Best Practice Tip: Plan communications ahead of an incident

Across your organization, there are many different ways to communicate and types of messages. Emergencies are the most common urgent communications to employees; however, several other timely messages such as a system outage are also quite common, especially as the data from the 2019 survey shows that  cyber attacks/system outages were one of the most common incidents experienced by employees within the last year. 

Katharine advised that organizations outline the potential time sensitive, business critical scenarios they might encounter as demonstrated on the slide below.

Once the landscape of potential emergency scenarios is known, Katharine says that organizations should put the following steps in place to ensure their emergency communication procedures are sufficient ahead of an emergency:

1. Define what constitutes a routine, timely or urgent communication
2. Define terms and use clear language
3. Establish policies for the frequency and level of communication
4. Have up-to-date contact information
5. Leverage precreated messaging templates (like the ones featured in this nifty guide)
6. Identify alternates and backup plans
7. Don't forget to PPT: Practice, practice, test

Trend #2 Shows Mobile Communication Remains a Top Method for Critical Communications

Survey participants were asked about the current emergency communication methods in place at their workplaces as well as what they prefer. An overwhelming number of employees currently receive emails for emergency communications, but half of all respondents would prefer a mass text message.

In addition to preferred communication methods, Katharine narrowed in on the percentage of respondents who traveled at least 25% of more in their current role and are considered to be lone workers. She brought up a good point that in 2020, approximately 105 million mobile workers will be working in the U.S.

Best Practice Tip: Protect Lone/Traveling Workers

Katharine recommended that organizations provide a safety net to only worker in the office, but also those who are traveling or are working offsite. Katharine identified two key advances in technology that help provide that virtual safety net:

• Location-based alerts: Organizations using a mass notification system can tap into features that allow alerts to be sent to a specific location so that only employees in affected areas can get the alert
• Geo-poll responses: Similarly, an alert can be set up to include a question or require a response that can be categorized and aggregated into similar answers; Message delivery can also be tracked

Katharine suggests that organizations look into deploying real-time monitoring and communications so employees have the two-way communication and resources to get the help they need. 

Want to hear two additional key findings and best practices? Listen to the webinar recording here.

Don't forget to download the 2019 Workplace Safety and Preparedness Survey while you're here. 

If you haven’t heard by now, Rave’s Annual Summit will be taking place at the DoubleTree by Hilton Orlando at SeaWorld from April 8-10, 2019. For the 10th annual Rave Summit, we are thrilled to announce that David O. Brown, former Chief of the Dallas Police Department, will be the opening keynote speaker! 

We are honored to have Chief David Brown speak at this year's summit in Orlando. The Dallas police chief inspired a nation with his response to the killing of five of his officers in 2016. The New York Times reported that Brown has "earned a national reputation as a progressive leader.” After 33 years with the Dallas Police Department, he continues to be a beacon of hope and unite communities through a dedication to transparency and trust. Now a correspondent for ABC News, Chief Brown is the author of the powerful memoir, Called to Rise: The Power of Community in a Nation Divided. We can't wait to see his presentation in April!

For new Rave Customers, this might be the first time you are hearing about #RaveSummit. For customers who have been partnered with us for many years, you might have attended or thought about attending. Our customers often ask us, “What will I get out of attending?”. In addition to seeing keynote speaker Chief David Brown, here are some of the top highlights:

Summit Overview:

	Attend sessions – Learn how leaders are leveraging Rave for stronger & simpler communications when it matters most. You’ll get to hear case studies across industries, departments, and geographies.
	Join us in the Guru Lounge – Dive deep into your Rave environment with the folks that created it and get your questions answered.
	Meet your industry peers – Recharge with coffee and snacks during breaks, or dance the night away at networking events. There’s something for everyone.
	Thousands of opportunities to learn – Transform the impact of your role with the knowledge you’ll get from keynotes, trainings, breakout sessions, and hand-on learning to help grow your success with Rave.
	Connect with fellow users – Make connections that go well beyond a platform. Have more fun than an actual rave. Endless opportunities to network.

Related Blog: Top Things to do in Orlando While You're at Rave Summit

We thought for years the biggest benefit customers got from attending was being able to sit down and have a meal or a beverage with our product team, executive team and the folks at Rave who design and build the solutions they use to enhance safety and communications. We were not wrong with that assumption, but might have been narrow sighted. The truth is customers hear from us a lot, but want to hear from each other even more! Sure, it’s awesome to hear road maps and give feedback to the people who build products at Rave, but we’ve heard the interactions and conversations between customers who attend the Rave Summit can be even more valuable.

Attendees from last year's Summit overwhelmingly said their favorite part of the conference was talking to a school of their size or county/city of their population about how they made the most use of their Rave products. How they overcame similar challenges, collaborated with other schools, counties or companies around emergency communication. Listen to how someone with a similar role and responsibilities as you in a different state handles the same situations you deal with day to day, and provide them with more perspective and lessons they can apply in their community.

So when you ask yourself, "Should I go to Orlando this year?", take into account the warm weather, networking events, powerful keynotes, product training, and guru lounges - but don't forget about inspirational insights, solving problems and creating valuable industry relationships. 

We've combed the world's most popular travel blogs to find the top five security and safety tips for corporate travelers. We also suggest a solution for busy corporate travel managers that can reduce the volume of travel administration and enhance the level of protection for traveling employees.

Traveling can be fun for employees, but it can also be dangerous. When your employees are traveling abroad to meet clients, there can be numerous things on their mind that take priority over personal safety. They might be too busy thinking about the presentation they need to deliver or the objections they might face during their meeting. 

Because of these distractions, the most common threats to corporate travelers are non-violent crime (i.e. pickpocketing), traffic accidents (due to driving while distracted) and food poisoning. They are not “exciting threats”, but they happen every day - even in so-called “safe” destinations such as Europe.

Therefore, whereas many articles offering security and travel tips for corporate travelers advise travelers to stay clear of countries in the midst of a civil war, we would like to give our attention to the “everyday” threats statistically more likely to result in loss, injury, or a need for medical attention.

The Top 5 Security and Safety Tips for Corporate Travelers

Our top security and safety tips for corporate travelers have been compiled with both travelers and travel managers in mind. Naturally the tips don't cover every possible scenario, but our common sense approach to security and safety should protect travelling employees in most circumstances.

There is No Substitute for Solid Preparation.

If your employee has not visited their destination previously, it is essential theyresearch its location, the area around theirhotel, and safe neighborhoods to explore. The U.S. Department of State's Bureau of Consular Affairs has an excellent website for general information; but for more localized and up-to-date information, the best source is the community forums on Trip Advisor.

Once the trip is planned, copies of their passport, travel documents, insurance, driver's license, credit card and itinerary should be scanned and saved to an online source where they can be easily retrieved if they are lost or stolen. The online source should be accessible by both your employee and you in case they are incapacitated during their trip.

Your employee should also prepare a directory of telephone numbers they may need during their trip. This directory should also be accessible to you as the corporate travel manager and include the numbers for airline(s) they are flying with, hotel(s) they are staying at, car hire firms, clients they are meeting and other key contact information. Emergency services numbers are dealt with below.

Remind your employees to not make themselves an easy mark for petty crime.

If your employees are smart enough to negotiate international airports, they probably don't need telling not to stand out from the crowd by wearing expensive jewelry or carrying top-of-the-range luggage. However, what they might not realize is that they can be most vulnerable to pickpockets and other petty criminals when their security awareness is at its highest.

A seasoned international traveler wrote an interesting post on Quora.com in which she explained how petty criminals loiter around signs warning of the presence of pickpockets. The natural instinct when you see one of these signs is to check your jacket, pants, or other pockets to make sure your valuables are secure - showing the petty criminals exactly where your valuables are located.

The author of the post advocates keeping valuables in unusual places (although she doesn't suggest where) and resisting the temptation to check your jacket, pants or other pockets when you see the warning signs. This is one of those valuable security and safety tips for travelers that is equally as valuable in domestic situations as when your employees are traveling abroad.

Stress the importance of best cybersecurity practices.

Most articles offering security and travel tips for corporate travelers fail to take account of cybercrime. According to the FBI, cybercrime is responsible for the theft of around $300 billion in intellectual property and business intelligence each year - a figure that may well be underestimated due to businesses failing to report thefts because of reputational damage and loss of investor confidence.

Cybercrime is a real hazard “on the road” due to corporate travelers using unsecured Wi-Fi services and treating publicly-accessible Internet connections the same as if they were secure workplace networks. In 2016, a survey by Kaspersky Lab's revealed business travelers are more likely to be mugged of valuable private and corporate data than of their travel money.

According to the survey, one in five people have been a target of cybercrime while abroad, rising to almost a third of senior business managers. Kaspersky Labs attributes the higher rate of “senior” vulnerability to business managers remotely logging in as quickly as possible upon arrival because there is an expectation they will stay connected during their trip.

Make it easy for your employees to let you know where they are at key times.

Even though travel managers might have a copy of an employee's itinerary, it is a best practice to have a channel of communication available at key times so they can let you know when they are departing the hotel or arriving at a meeting. The reason for checking in at these key times is because these are the occasions employees are likely to be exposed to the highest level of danger.

Whenever you read reports about travelers going missing, their disappearance is often not noticed until days later - giving local law enforcement little to go on. However, if you were to message your manager to let them know you were leaving your hotel, and expected to arrive at your destination within thirty minutes, your manager would be instantly aware something had happened if you failed to check in.

A dedicate channel of communication can also be of value to alert corporate travelers of local disruptions they should keep clear of. Alert notifications can also communicate bad weather, terrorist attacks and other emergency scenarios that could affect your safety while travelling abroad.

Get emergency help to your employees when something goes wrong.

Despite preparing solidly and implementing travel best practices, there are times when things go wrong. For example, no matter how carefully you have researched, it is impossible to tell when you may be served a dish of poorly prepared shellfish. In these circumstances, it is important to have access to English-speaking emergency services and to inform your manager of the problem.

Telephone numbers for English speaking emergency services should be researched in advance and programmed into your employee's phone. Where a texting service exists similar to text-to-911, that number should also be included if it differs from the voice call number. 

A Simple Solution for Busy Corporate Travel Managers

While some apps are excellent for when you are badly hurt in an accident, you could end up downloading apps for every circumstance you are likely to encounter on your travels - e.g. apps exist for Trip Advisor, secure communications, and emergency notifications. Alternatively, a simple solution for busy corporate travel managers is an employee safety app that ties directly to corporate safety resources. 

An employee safety app enables corporate travel managers to keep all the resources each traveler will need in a secure content portal that can be accessed both via the app and online. The app can also be used to send and receive messages securely using the same encryption technologies as used by leading financial institutions.

With regard to checking in during travels, some apps have a virtual safety timer that - once activated - counts down to zero before sending an alarm to travel managers. You can track the location of your employee's phone through the management portal and alert emergency services to their lack of response - saving valuable time in providing essential help, and possibly saving their life.

Your employee will also be able to receive geo-targeted alert notifications via the app, and get emergency help when something goes wrong with two taps of your smartphone screen. Effectively, a robust employee safety app can be your employee's virtual travel companion wherever they go - enhancing their level of protection, and providing a reliable means of communication if ever they need assistance.

Addressing Traveling Worker Safety Challenges

In October 2016, Ipsos MORI conducted a global survey targeted to those who organize, influence, or are responsible for their business's travel and risk mitigation policies. The survey (PDF) found the three biggest challenges to protecting corporate travelers are:

• Educating employees about travel risks.
• Communicating with employees during a crisis.
• Tracking employee travel and their whereabouts.

An employee safety that can integrate with your corporate emergency notification system is the simple way to address these challenges with minimal administration and easy implementation.

Workplaces everywhere are exploring ways to improve employee communication. From improving executive leadership transparency to communicating healthcare benefits, workplaces are constantly looking for ways to optimize the delivery and receipt of key messages. One emerging area of workplace communication involves urgent communications.

Urgent communications to employees are messages that must be read or received immediately as the subject involves something that may affect an employee's safety, ability to work or some other catastrophic event. In some cases, the message might just be alerting employees that a situation is unfolding such as a report of a power outage or it might contain an action such as reaching out to resources if needed during a hurricane.

The Different Types of Workplace Communication

According to Sandler Training, there are four different types of workplace communication. Here we focus on three as they pertain to urgent communications.

1. Verbal (In-Person) Communication: Communicating in person is the easiest and most efficient way to deliver an urgent message to employees as you can target a large group all at once and can answer any immediate questions to clear up any confusion. You also have a better opportunity to manage employees' concerns as you can clarify and provide more detail about an unfolding situation. However, this method only works if all of your employees are in the office, of course. As we've seen, this will not be the ongoing case for many workplaces with a growing remote worker population. 

2. Phone Conversations: Delivering urgent messages through a phone conversation is similar to in-person communications as again the employee has the chance to ask questions to clear up confusion. It's not as effective on a mass scale even when call trees are used. In one of our past blogs "Comparing Notification System Tools for Critical Communication", we took a deep dive into the various communication methods a workplace may use to communicate with employees. Call trees fall short in delivering urgent communications as the successful delivery of a message depends on the continuous chain of the call tree system. 

3. Written Communication: This type of communication involves emails or memos and according to Sandler Training, "...is the one that can lead to the most misunderstandings." While it can be quite easy to shoot of an email about a critical situation, you risk employees misunderstanding your message and possibly heightening their concerns. This is where understanding the art of short communications is key. The Higher Education industry are masters at short communications as they are required by the Clery Act to outline the scenarios that may require a timely notification or means for alerting students and faculty. Several colleges and universities use mass notification systems with pre-built message templates to deliver common urgent communications. 

Urgent Communications As An Additional Type of Workplace Communication

We recommend that urgent communications be considered as an additional type of workplace communication. Unfortunately, the rise of catastrophic events such as natural disasters are leading businesses to seek more efficient ways to quickly communicate with their employees; oftentimes, mass notification system software or MNS is what they use. According to Robert Brooks, a Security & Building Technologies Analyst for IHS Markit, "In the Americas, hurricanes, tornadoes and earthquakes are occurring more frequently, so unimpeded mass communication during these events is critical. MNS software is often employed so companies can communicate with their employees, federal agencies, university students and the general public." 

In fact, a recent survey report "Workplace Safety and Preparedness Trends" found that one of the top three most common emergencies experienced in the workplace within the last year was severe weather events. 

Emergency professionals are trained and prepared to deal with every unexpected situation imaginable. 9-1-1 serves as the incident command during times of emergency. They dispatch resources to the scene like first responders who are given essential information, follow procedures and work as a team. 

What is Self-Dispatch?

Self-Dispatch is when any person shows up to an active scene without being sent by 9-1-1. Self-Dispatching is seen most often in two different scenarios:

One example of self-dispatching occurs when an off-duty public safety professional like a police officer responds to an incident. They might hear something over the radio or be in the area of an active situation and go to the scene of the incident without knowing crucial details or specific protocols for the situation. While they have high level information like the location, problems arise when safety professionals decide to self-dispatch. Solo missions lead to increased risk for everyone involved.

The other scenario is when everyday citizens or even off-duty emergency professionals decide to self-dispatch. They may hear information about an incident in real-time on the news, through a friend or read an update on social media. It may seem heroic, but acting on this unreliable information unnecessarily adds to the chaos and danger involved for all.

Lack of Information

When 9-1-1 takes a call, the dispatcher enters all the information they receive into their system to share with the first responders sent to the scene. The critical information they collect and share ranges depending on the incident, but includes life-saving facts like location within a building, personal information and details of what’s happening on the scene. The physical and mental health of any citizens involved in the initial call are also important factors for dispatched resources to know when assessing risk.

Self-dispatchers don’t have access to this critical information. By reacting to information overheard on the radio or news, they are missing the full picture and are walking into the situation blind. Police cars 20 miles from an incident will receive an alert about it. Cars from several different towns may start heading towards the danger, but they are often on different radio bands and not communicating. These uncoordinated efforts result in multiple protocols being broken. Not having the correct information needed hinders organized rescue efforts.

Easily identifiable safety vests are often given out to approved first responders so they can be easily recognized by citizens and among each other. This helps people know to get out of their way. Self-dispatchers can be difficult to identify in a chaotic situation, creating a lack of information for all the responsible parties.

Risk for First Responders

There is always a risk for any first responders when first entering a scene. Critical situations can involve risks including chemical, biological, radiological and explosive devices. These natural and man-made disasters are a threat to anyone on scene, but even more so when a self-dispatcher arrives blind to the already risky situation.

Uncoordinated resources like self-dispatchers add additional risk for emergency personnel. If an on-duty police officer decides to self-dispatch, they are leaving the area under their supervision without notice. Lives are at risk when safety personnel leave their local communities. It reduces the level of protection and support should a second emergency occur, making the area more vulnerable.

Self-dispatchers also take away resources from fire-fighters and other emergency personnel assigned to the scene. When 9-1-1 dispatched resources arrive on location, they are all aware of the procedures in place for the incident at hand and are accounted for. During the Ferguson riots of 2014, police officers arrived to help without riot gear. Resources are limited, and without the proper equipment like shields and gas masks, responders are on no value on the front line.

When resources show up that have not been requested, the incident management system fails. The scene of an emergency is already chaotic, and self-dispatchers create additional risks for emergency professionals that are unnecessary and avoidable.

Reduced Awareness

Self-dispatchers don’t have context into the scene they’re walking into. They don’t know what to prepare for or have access to floor plans to know where to go. Self-dispatchers enter the scene blind with zero situational awareness.

The International Association of Fire Chiefs (IAFC) and the National Volunteer Fire Council (NVFC) discourage the practice of self-dispatch among emergency response personnel to emergency incidents without notification or request. The association sites that in past incidents, fire departments have struggled to allocate additional resources to managed self-dispatchers that arrive on scene. This uncontrolled and uncoordinated arrival of self-dispatches at emergencies creates accountability issues as well as an additional safety risk to all because they are not aware of the overall strategic plan.

On-Site Confusion

9-1-1 centers are responsible for everyone on-site during an emergency. This includes the citizens that called, the deployed first responders, and many other involved groups depending on the situation. 9-1-1 is accountable when self-dispatchers arrive, creating a hindrance. Not only is the call center dealing with the situation at hand, they also have to worry about this additional liability.

9-1-1 also puts all first responders in the same notification chain – sheriffs, police agencies, safety officers, authorities, and more. This allows all involved parties to stay informed and take appropriate action immediately. If a community has a critical communications system in place, (like Panic Button) they can share critical response data for enhanced coordination between authorized app users, 9-1-1 call takers and first responders that saves time when it matters most. This streamlined communication helps reduce confusion.

The report detailing the Sandy Hook shooting response was released January 2018. The report states that search and clear procedures at the school were difficult because of the number of personnel who self-deployed from multiple agencies. Self dispatchers creates unnecessary on-site confusion.

Incorrect Targets

Any new or unidentified person in an active shooter incident is seen as a suspect. First responders that have been properly dispatched are put at a disadvantage by having identify and to account for self-dispatchers. By blocking 9-1-1, self-dispatchers put themselves on an island are isolated from necessary communication from the teams in charge.

Other Adverse Consequences

There are many reasons why 911 help is needed, and self-dispatch only helps in niche scenarios. In schools, towns, and organizations everywhere, a majority of 9-1-1 calls are related to medical issues. A student breaking her arm or employee having an asthma attack needs streamlined communication to get help fast. Self-dispatching is can’t help day to day instances that 9-1-1 is often called for. Organizations relying on self-dispatching as their safety plan won’t get any assistance from self-dispatchers on their most common and daily incidences.

Every child is taught to dial 9-1-1 during an emergency and get help from the experts in charge. When you were growing up, you were never taught to self-dispatch. Self-dispatching goes against this core lesson we were all raised knowing and blocks 911 from entering the process.

It is understandable that off duty first responders and everyday citizens would want to jump into the fray to help instead of sitting idly by. Self-dispatch may seem appealing to some school administrators. Those who have never been involved with Public Safety Answering Points (PSAP) like 9-1-1 call centers may think self-dispatching is a cure all. However, emergency situations have the most positive outcomes when plans are in place, protocol is followed, and communication is straightforward. Only people with direct insight into the coordination of the situation, like dispatchers, have the required knowledge and capacity to decide what resources are needed when and where to eliminate additional chaos during an emergency.

Notifying 9-1-1 is a crucial first step and should never be bypassed during an emergency. Rave Panic Button is only solution that immediately provides 9-1-1 the type of emergency, location of incident, and has direct access to floor plans, access points, and other key facility data through software installed at the 9-1-1 center. Through this direct integration with 9-1-1, 9-1-1 serves as incident command and can dispatch proper resources to respond to the scene and initiate real-time communication with school administrators and key staff through the Rave Panic Button app. Rave Panic Button shortens response times, reduces confusion, and improves safety for all those in the immediate area by providing immediate information to 9-1-1 and key personnel with a single button push during the first crucial seconds of an event.

The Spiceworks survey - “The State of IT 2019” - was conducted with the cooperation of 780 business technology buyers from organizations across North America and Europe. Slightly less than half of respondents came from the U.S., but these were the happier of the technology buyers - 42% stating that their IT budgets for 2019 were going to increase compared with 34% of technology buyers from Europe.

Surprisingly - considering the big thing at the minute supposedly to deploy assets in the cloud - only 21% of U.S. organizations' IT budgets are earmarked for cloud computing and cloud-based hosted services. The largest chunks of the budgets are allocated for hardware (33%) and software (29%), with 11% of IT budgets going towards on-premises managed services and the remaining 6% covering other IT costs.

A Deeper Look at IT Budget Allocations

The breakdown of proposed hardware expenditure makes fascinating reading. Smaller organizations plan to spend least half their hardware budgets on replacing desktop computers, laptops, and servers, while larger organizations (1,000+ employees) are more focused on enhancing their existing security. Indeed, the larger an organization gets, the more it allocates to external data storage services.

When it comes to spending money on software, the biggest expenses tend to be upgrading existing on-premises operating systems, and investments in virtualization, productivity apps, and security. Again the priorities differ slightly the larger the organization, with many larger organizations allocating a notable slice of their IT budgets for 2019 on disaster recovery and in-house developer tools.

Of the 21% of IT budgets being spent in the cloud, Infrastructure-as-a-Service only accounts for between 4% and 11% of spend depending on the size of the organization - a fairly small proportion considering the percentages being allocated to web and email hosting (average 19%), online backups (average 15%), and productivity improvements (average 11%). It's like cloud computing never happened!

The Top Drivers behind the Increased IT Budgets

One of the most common reasons given for U.S. businesses increasing IT budgets in 2019 was to replace end-of-life hardware and upgrade existing systems. One of the driving factors behind this need to replace and upgrade is because support for Windows 7 and Windows Server 2008 is ending in January 2020; but many organizations also reported additional purchases were required due to business growth.

For organizations who had already prepared for support being withdrawn for Windows 7 and Windows Server 2008, their focus is fixed on new and emerging technologies. In Spiceworks' accompanying report - The State of IT Budgets 2019 - it is revealed organizations' biggest new tech investments over the next two years will consist of IT automation and Wi-Fi networking with smaller investments being made in:

• The Internet of Things (IoT)
• Hyper-Converged Infrastructures
• Container Technology
• 3D Printing
• Edge Computing
• Serverless Computing
• Virtual Reality
• Artificial Intelligence
• Blockchain Technology

Which Industries Have the Most Money to Spend?

Breakdowns by industry were not included in the Spiceworks report, so we have to look elsewhere to find out which industries have the most money to spend. Fortunately Deloitte recently published an article entitled “Technology Budgets: From Value Preservation to Value Creation” in which CIOs reporting increased IT budgets came from the following industries:

• Insurance (59%)
• Healthcare Services (58%)
• Travel, Media, and Hospitality (57%)
• Education and Nonprofit Organizations (52%)
• Banking and Securities (51%)
• Professional Services (48%)
• Retail Businesses (47%)
• Construction Industry (45%)
• Energy and Resources (39%)
• Telecommunications (36%)

(Figures in brackets relate to the percentage of CIOs in each industry reporting increased IT budgets)

The “Value Preservation to Value Creation” element of the report´s title relates to the percentages of IT budgets being used to maintain operations, make short-term changes to improve revenues, and support long-term innovations for underlying growth. These percentages varied according to the risk appetite of each industry, with telecommunications companies being the far more adventurous industry sector.

What these Figures Tell Us about Future IT Budgets

These figures make positive reading for the future of IT budgets. Although a significant amount of money is being allocated to replace and upgrade existing infrastructures, once these capital expenses are accounted for, they will not have to be repeated in the short term - leaving more funds available to invest in new technologies in order to drive business agility and innovation.

The relevance of complying with OSHA's guideline safety controls for home healthcare workers has recently taken on greater significance due to proposals filed in Congress which call on the Secretary of Labor to issue an enforceable safety and health standard similar to OSHA's guidance.

At the end of last year, Connecticut Rep. Joe Courtney introduced a Congressional bill entitled the “Workplace Violence Prevention for Health Care and Social Workers Act” (PDF). The bill, if passed, will direct the Secretary of Labor to issue an enforceable safety and health standard similar to OSHA's “Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers” (PDF).

Although a number of states have implemented workplace violence prevention programs for healthcare facilities, many of the programs are location-specific inasmuch as they only address threats in certain areas such as Emergency Rooms or Psychiatric Units. What is significant about OSHA's Guidelines is that they take into account the risks faced on a daily basis by home healthcare workers.

The Risks Faced by Home Healthcare Workers

The risks faced by home healthcare workers are exactly the same as those faced by on-premises healthcare workers - typically violence, verbal aggression, and sexual assault. The difference between the venues is that when a home healthcare worker is attacked, the event occurs when they are working alone and isolated from the safety controls one would find in a healthcare facility.

Unfortunately, it is impossible to quantify how many home healthcare workers are the victims of violence, verbal aggression, and sexual assault due to significant underreporting. However, one survey reported healthcare workers working in the community were twice as likely to experience violence or aggression at work as on-premises healthcare workers.

Administrative Safety Controls for Home Healthcare Workers

OSHA's administrative safety controls for home healthcare workers appears under the “Administrative and Work Practice Controls” of the guidance. The safety controls divide responsibility for safety between nursing managers and home healthcare workers inasmuch as nursing managers are responsible for providing relevant training and developing safety procedures, while workers have a duty to report all assaults, attempted assaults, or threats of assaults, and maintain logbooks of such incidents.

In addition, home healthcare workers should have specific log-in and log-out procedures that require them to contact their nursing manager's office before and after each patient visit. The log-in/log-out procedures should include:

• The name and address of the patient being visited.
• The expected duration of the visit.
• A code word to use in the event of an incident.
• Details of any travel plans with the patient.

The home healthcare worker must contact the office if the plans change or the visit overruns, while office personnel must have procedures to follow if a worker fails to log in as expected.

Physical Safety Controls for Home Healthcare Workers

When working in an environment where there is a high risk of an assault, OSHA recommends implementing a “buddy system”, or giving workers the discretion to receive back-up assistance from another worker or a law enforcement office. In every event, OSHA's guidelines state workers have an effective means of communication, and suggests a cell phone or panic button.

Although OSHA is technology neutral when it comes to suggesting what type of personal safety or panic button system is implemented, it makes sense to use a smartphone app rather than a wearable device that connects via Bluetooth to a smartphone - the reason being that, with a wearable device that connects to a smartphone, personnel have to keep two devices charged instead of one. There is also more likelihood of a wearable device being forgotten and some Bluetooth-enabled panic buttons have been found to have security flaws which may make them unreliable safety controls in an emergency.

A Smartphone Personal Safety App for Home Healthcare Workers

By comparison, one personal safety mobile app provides location-based alerting to security or 9-1-1 with a tap of a smartphone screen. Nursing managers are simultaneously alerted to an attack to facilitate a coordinated response, and the event is automatically logged on a management console. Employees can be provided with a virtual escort every time they travel.

Community nurses, personal home care aides, and other traveling staff practice in some of the most dangerous situations in the healthcare industry, often without nearby support. Our new report demonstrates how technology can empower traveling healthcare workers' personal safety.

The healthcare industry is one of the most dangerous places to work in the U.S. In addition to a high rate of occupation injuries due to musculoskeletal disorders, exposure to pathogens, and slips, trips, and falls, incidents of serious workplace violence are four times more common in the healthcare industry than in private industry on average according to data from the Bureau of Labor Statistics (PDF).

In reality, the situation is likely to be much worse. A survey conducted in 2013 by the Wayne State University of Medicine in Detroit found a workplace violence underreporting rate of 77% - which increased to 88% due to supervisors failing to document reports. One of the reasons given for the underreporting rate is that the victims of workplace violence did not know how to make a report.

The Level of Threats to Traveling Healthcare Workers' Personal Safety

The results of the Detroit survey invalidate many other statistics relating to workplace violence in healthcare. Therefore, although it was claimed by the New England Journal of Medicine that 61% of community nurses, personal home care aides, and other traveling staff report workplace violence annually, the actual number of victims could be considerably higher with the consequence being that, without full knowledge of the scale of workplace violence, prevention efforts are mostly inadequate.

However, assuming the rate of underreporting is equally dividing between on-premises healthcare employees and off-premises healthcare employees, a survey published in the British Medical Journal found that nurses working remotely were twice as likely to experience violence or aggression at work as those working on-premises. The discrepancy was attributed to patients' homes being uncontrolled work environments in which none of the usual safety features of a healthcare facility were present.

Efforts to Reduce Workplace Violence in the Healthcare Industry

What efforts have been made to reduce workplace violence in the healthcare industry have mostly occurred at state level. Forty-two states have legislation on their statutes that either establish or increase penalties for violence against healthcare professionals, and eight of these states also make it a licensing requirement that healthcare facilities run workplace violence prevention programs.

OSHA has also developed guidance for employers and workers in healthcare and social services (PDF), and this guidance has recently become the backbone of a federal bill introduced into Congress by Connecticut Rep. Joe Courtney - with a significant difference being that the language of HR 7141 (PDF) includes a reference to home health care workers, which is noticeably absent from OSHA guidance.

How Tech Empowers Traveling Healthcare Workers' Personal Safety

Courtney's “Workplace Violence Prevention for Health Care and Social Workers Act” does not go as far as Oregon's state legislation for protecting home health care workers. The state's HB 2022 from 2007 (PDF) stipulates that home health care workers have the right to refuse to treat a patient unless they are provided with a “communication device” with which they can alert law enforcement to an assault.

Since 2007 - the year when the first iPhone was released - the range of communication devices available to empower traveling healthcare workers' personal safety has improved dramatically. It is now possible for traveling healthcare workers to download smartphone apps that can alert law enforcement to an assault with two touches of a screen, or that can be used by employers to alert employees of an emergency situation.

Further Benefits of Smartphone Apps for Traveling Healthcare Workers

Apps with a safety timer can be used as virtual escorts to alert employers quickly to a potential assault situation when a timer is activated, or they can be used as a directory of resources for healthcare personnel who have experienced a non-physical assault (i.e. car theft). Importantly the apps can also be used as a means of reporting and recording workplace violence in the healthcare industry so that the scale of the issue becomes more apparent and more effective prevention methods are implemented.

Healthcare managers with a responsibility for the health and safety of community nurses, personal home care aides, and other traveling staff can find out more about how tech empowers traveling healthcare workers' personal safety by downloading our new free report. 

Although OSHA enforces a duty of care on employers to protect staff from foreseeable hazards and has produced guidelines for preventing workplace violence for healthcare and social service workers, most state laws to prevent workplace violence in the healthcare industry fail to protect traveling nurses.

In 2015, a study published in The BMJ revealed that traveling nurses working in the community are twice as likely to experience workplace violence as nurses working on their employers' premises. Although the study was based on community nurses working in the Australian health service, its results mirror those of studies conducted in the UK and elsewhere in Europe.

In the U.S., it is difficult to find accurate statistics relating to workplace violence in the healthcare industry due to substantial under-reporting. To further complicate the distinction between violence directed at traveling nurses and on-premises nurses, OSHA combines home health aides, nursing aides, and psychiatric aides in its Workplace Violence in Healthcare report (PDF).

State Laws to Prevent Workplace Violence in the Healthcare Industry

Despite the under-reporting of workplace violence in the healthcare industry, it has been calculated that the rate of serious workplace incidents (those resulting in workers taking time off to recover from their injuries) is four times higher in the healthcare industry than an average of all other industries combined. To counter this alarming statistic, OSHA provides a series of workplace violence resources:

• Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers (PDF)
• Preventing Workplace Violence. A Road Map for Healthcare Facilities (PDF)
• Workplace Violence Prevention and Related Goals: The Big Picture (PDF)

Many states have increased the criminal penalties for violent assaults on healthcare personnel. However, a number of these laws are “location-specific” (i.e. only apply in Emergency Departments) and fail to take into account violent assaults on healthcare personnel working outside the healthcare facility. Indeed, of nine states that have passed legislation requiring healthcare facilities to implement workplace violence programs, only Oregon's laws specifically address “Home Health Care Services”.

Hope that Federal Action Improves Safety for Traveling Nurses

The failure of state laws to protect traveling nurses is not necessarily the fault of state legislators. Without accurate statistics to work with, many legislators will be unaware of the scale of violence experienced by traveling nurses, so measures are not introduced to address it. Fortunately, proposed action at the federal level may result in better protection against workplace violence for traveling nurses.

Last November, Connecticut Rep. Joe Courtney introduced his Workplace Violence Prevention for Health Care and Social Workers Act (HR 7141). The bill calls on the Secretary of Labor to issue an enforceable safety and health standard similar to OSHA's Guidelines for Preventing Workplace Violence for Healthcare and Social Service Workers, but with home health care workers specifically mentioned.

Although the bill has not yet progressed any further than the House Committee on Education and the Workforce, it has some notable co-sponsors - including Rep. Ro Khanna who contributed to California's Workplace Violence Prevention in Health Care standard (PDF) and who introduced his own federal proposals last March (PDF), which significantly contained a section about security communication devices for traveling nurses.

The standard promulgated under this paragraph shall include procedures for hazard evaluation and control that fit the work settings unique to home health and hospice, which shall include, but not be limited to, each of the following:

(A) Procedures to identify and evaluate environmental and patient-specific risk factors such as the presence of weapons, evidence of substance abuse, or the presence of uncooperative cohabitants. At minimum, such procedures must be utilized during intake procedures, at the time of the initial visit, and during any subsequent visit when there has been a change in conditions.

(B) Procedures to correct workplace violence hazards in a timely manner, which shall include, at minimum, procedures to ensure employees will not work alone in households where there is a high risk for violence, provision of functional and maintained security or communication devices for all employees working in a patient or client’s home or community, and provision of dedicated and available security personnel to respond to reports of violent incidents or threats.

(C) Procedures for responding to actual or potential workplace violence emergencies that shall include, at minimum, obtaining help from security personnel required under subparagraph (B), or law enforcement agencies as appropriate.

Khanna Not the First to Call for Security Communication Devices

Rep. Ro Khanna's bill is not the first set of proposals to call for security communication devices for traveling nurses. Oregon´s laws to address workplace violence on traveling nurses stipulates employers must measure the frequency of assaults in the homes of patients receiving home care health services and - regardless of the outcome - employees may refuse to treat a patient unless “equipped with a communication device” they can use to alert law enforcement to an assault.

Although no other states have introduced similar measures to protect traveling nurses, several hospitals have implemented solutions that give traveling nurses one-click access to law enforcement. This solution also receives geo-targeted alert notifications and can act as a virtual escort so healthcare managers are informed when a nurse has been unexpectedly delayed at a patient's home or failed to arrive for their next appointment.

We are only a few weeks into the new year, and workplace safety has already become a major point of conversation in 2019. At Rave, we have noticed a recent interest increase in our corporate safety related content, and these topics show no signs of slowing down. We predict that emergency preparedness will continue to grow in relevancy for business organizations as 2019 continues. 

Critical communications for businesses have become much more in depth over the past few years. Implementing and maintaining corporate emergency plans involve many moving pieces to consider, including technology and communications trends. Here are five pieces to get up to speed and gain insights into modern workplace safety:

1. Survey Analysis: Workplace Safety & Preparedness

Click here to view now.

Last year, Rave surveyed more than 500 employees from various industries across the US about employee perceptions on workplace safety. We have complied our findings into the Workplace Safety and Preparedness Survey Analysis.

Discover the top highlights including insights into preferred communications methods. The analysis also dives deep into findings like generational differences in knowledge of company emergency preparedness plans and more.

Click here to access the survey results >>

2. Case Study: Hurricane Crisis Communication at Medical University of South Carolina

Click here to view now.

In September 2018, Hurricane Florence barreled towards the Carolinas. The crisis communication team at the Medical University of South Carolina (MUSC) enacted its response plan six days prior to landfall, sending messages out to 23,400 members of its campus community.

Read the case study to learn about MUSC’s approach to crisis communications and best practices to communicate with its community, whether on a daily basis or during a natural disaster such as Hurricane Florence.

Learn more about MUSC's experience >>

3. Trend Report: Emergency Preparedness and Security Trends in Healthcare

Click here to view now.

Our survey results examine the current and most pressing emergency concerns for hospitals and healthcare facilities. Learn what respondents consider their biggest safety concerns, what actual events occurred within the previous two years, and what issues they had encountered when communicating emergency incidents to employees, patients, and visitors. The report also identifies several issues with how emergency incidents are communicated.

View the full Healthcare report here >>

4. Whitepaper: Emergency Notification Systems Evaluation: 6 Overlooked Criteria

Click here to view.

Your Emergency Notification System should be evaluated regularly to ensure you are aware of the system capabilities and limitations as well as how these areas may be impacted by advancements made in today’s modern technology.

We conducted a full Emergency Notification Systems evaluation to ensure your corporate safety plan is stronger than just “good enough” when it comes to such lifesaving technology. This whitepaper outlines six areas outside of strict technical criteria that can make or break your emergency communication efforts.

Click here to view the criteria >>

5. Case Study: Multi-National Consumer Goods Manufacturer Sees Rapid Results

Click here to view now.

A global manufacturer of consumer goods was hurting from the cost of poor communications because of their ineffective home grown notification system. To improve communication speed and corporate resiliency, the corporation implanted a  fast, reliable mass notification system. Discover how the organization is now able to rapidly communicate information and saw a $189k return on investment from a single incident.

Read the full case study now >>

Corporate environments across the country are having conversations about safety and emergency preparedness. Last year, more and more businesses began taking steps to protect against, communicate, and minimize the effects of an emergency situation. The past year has shown that emergencies and disasters can strike anywhere, anytime, including businesses. Now that is it 2019, the corporate security landscape goes beyond basics to keeps employees informed and safe.

Emergency preparedness is becoming more complex for businesses as technology, communication, and society continues to evolve. There is plenty of buzz surrounding safety solutions, and it can be tricky to cut through the noise. Discover top industry trends and gain actionable insights from subject matter expects at Rave Summit. Join Rave Mobile Safety, our partners, customers, and specialists as they help security professionals and industry peers learn the latest tricks, tips, and best practices in the evolving world public safety at #RaveSummit. Click here to learn more and register by January 31 to save 45% off registration!

Healthcare facilities find it harder to defend against active shooter threats than other soft targets because shooters in healthcare environments often have more personal targets and an apparently lawful purpose for entering the facility. The issue can be further complicated by healthcare providers remaining with vulnerable and elderly patients, and placing themselves at risk of injury.

Most active shooter events are impersonal in nature. Some - such as the Mandalay Bay shooting in Las Vegas last fall - are totally indiscriminate, while others - such as the recent Kroger grocery store shooting in Kentucky - are motivated by the hatred of a group of people due to their race, religious beliefs, or sexuality. Rarely is an active shooter motivated by the desire to kill or injure a person known to them.

The exception to this “rule” is active shooter events in healthcare environments. These can be both impersonal and personal in nature, and are commonly motivated by personal grudges, euthanizing an ill relative, or suicide. In many cases, the perpetrator had a lawful purpose for entering the facilities and would have passed ID checks to visit personnel, ill relatives, or physicians. Examples include:

• In November 2018, Juan Lopez entered the Mercy Hospital in Chicago on the premise of wanting to see his former fiancé Dr. Tamara O´Neal. Lopez started an argument with O´Neal, which concluded with four deaths - Lopez, O´Neal, a pharmaceutical resident, and a police officer.
• In August 2018, Richard DeLucia entered the Westchester Medical Center in New York to visit his terminally ill wife, Anne. DeLucia killed his wife before turning his gun on himself. Police later found a note at the couple´s home stating DeLucia wanted to end his wife´s suffering.
• In November 2010, John Jack - a former employee of the Palm Bay Hospital in Florida - turned up at the hospital ostensibly to say goodbye to his former colleagues. Although having no grudge against his former employer, Jack went into a back office and killed himself.

Metal Detectors and Armed Guards are Not the Answer

The installation of metal detectors at healthcare facilities does not necessarily stop active shooters. There has been a history of active shooters using guards´ guns to attempt an escape from Emergency Departments while in custody or while detained as a psychiatric patient. Research conducted in 2012 found that, of thirty shooting incidents in Emergency Departments between 200 and 2011, half were committed with a guard´s gun, while five other in-hospital events were also committed with a gun taken from a guard or other security personnel.

For this reason, many healthcare facilities are reluctant to arm guards with any form of weapon - especially as nursing staff feel compelled to remain with vulnerable and elderly patients rather than follow the recommended course of action in an active shooter scenario of run, hide, or fight. Instead, healthcare facilities are using technology to mitigate the potential consequences of an active shooter on their premises and give nursing staff as much warning as possible about the risk of danger.

Mitigating Potential Consequences with a Multifaceted Crisis Communications Platform

One of the technologies being implemented to help healthcare facilities communicate with employees during an emergency is a mass notification system. Having a system that would allow hospitals and healthcare facilities to communicate with all of their personnel, whether they’re on-site, working in the field or traveling to different locations, is vital so they can continue business operations, especially during an emergency. A multifaceted crisis communications platform would allow you to have two-way communications over multiple channels with all of your healthcare staff wherever they’re located, such as at the hospital, another part of campus or in a patient’s home. It would help you respond to your healthcare staff’s needs, offer them guidance and keep them safe.

If an incident occurs and you need to know about the safety and security of your traveling nurses, in-home caregivers and others, you can send out a poll to collect real-time location data of your traveling employees. A poll-based alerting system that’s integrated with your organization-wide mass notification platform allows you to gather poll responses and real-time location data from a select group of your workers through text and email. Through polling, your traveling healthcare staff employees can answer a question through email or a SMS text, automatically sharing their real-time locations. For example, if an adverse event occurs and you want to check on your staff, a poll can be sent out for a status update. Automatic follow-up alerts then can be sent out based on your traveling healthcare staff’s response and outline the necessary next steps.

Another way to empower your healthcare personnel to be ready for any situation is through an employee safety app. An employee safety app would help them if they need to act in an emergency or dangerous situation, while strengthening your connection with your staff. RNs, LPNs, personal healthcare aides and others would be instantly connected
to your emergency managers and other staff, so they can inform your safety and security personnel about what’s going on. Emergency procedures then could begin quicker. An employee safety app also would include an emergency call button, as well as the ability for
your healthcare staff to travel with a virtual escort and you to send targeted notifications.

Our top 5 workplace violence blogs reveals common themes running throughout. Typically, these are attributable to a lack of employee engagement, which can be understandable if the systems in place to enhance the safety of employees are not ideal for the environment or are being fully utilized.

The level of workplace violence in the United States is a difficult subject to quantify because of how it is defined. Whereas many people would consider the term “workplace violence” to cover acts of physical aggression in the workplace in which physical harm is suffered, the OSHA definition includes threats of physical aggression, any type of harassment, verbal abuse, and even passive aggression.

Consequently there is a wide disparity in workplace violence statistics due many business failing to comply with OSHA reporting regulations. Some of this disparity is attributable to businesses and employees not fully understanding OSHA's definition of workplace violence; but, as was revealed in our “Latest Workplace Violence Statistics” blog, there are significant discrepancies between the number of injuries reported to OSHA and the number of workers' compensation claims made each year.

Employers Have a Duty of Care towards Remote Workers

Furthermore, the duty of care to protect employees from violence in the workplace is not confined to any specific physical environment. Remote workers and lone workers should be given the same level of protection against violence as an employee engaged in an office or factory - particularly in the healthcare industry which suffers a higher reported incidence of workplace violence than any other.

A solution to keeping a pulse on employee wellness at all times was discussed in our “Business Continuity Management Tool” blog, along with recommendations about how the tool could be used to provide real-time employee location data, accurate employee status updates, and smarter communication for lone workers with it being necessary for employees to downloads apps.

Overcoming Communication Roadblocks for Critical Messages

Both on-site and off-site employees are subject to an ongoing barrage of communication “noise”, and this can prevent critical messages from getting through - a serious issue if an active shooter is on the premises or in the vicinity. Shootings accounted for 394 of 500 workplace homicides in 2016 and many communication systems are inadequate for warning employees of danger in an appropriate timeframe.

A comparison of communication systems and their effectiveness at alerting employees to the risk of danger was the subject of our “Notification System Tools” blog. The blog's conclusion was that a multi-modal communication system was the ideal solution for both emergency alerts and non-emergency communications - particularly one that encourages employee engagement.

Making Full Use of the Communication System in Place

Making full use of the communication system in place to support employee safety was a subject discussed in our blog “Four Questions to Ask Before Renewing Your Mass Notification Contract”. In the blog it was mentioned that a vendor should help businesses identify weaknesses in mass notification strategies and underutilized capabilities of the system that could help it reach its full potential.

It was also mentioned that businesses should not refrain from providing feedback if the communication system in place is not entirely appropriate for their environment. Vendors thrive on challenges to produce more effective and innovative solutions, and for this reason it is a good idea for businesses to seek employee feedback about the systems in place to protect them from workplace violence.

Delivering Faster Resolutions to Business Challenges

The final of our top 5 workplace blogs discusses “Overcoming 5 Business Communication Challenges”. It summarizes everything that has been mentioned above - rising above communication “noise”, proactively communicating, connecting with remote and lone workers, and receiving actionable feedback - plus adds using mass notification tools to deliver faster resolutions to business challenges.

The solutions suggested to overcome the business challenges and deliver faster resolutions include Rave Alert and Rave Guardian - two user-friendly multi-modal mass notification tools that include geo-polling capabilities to better engage employees and connect with off-site workers. The two tools encourage actionable feedback through two-way communication; which, in an emergency, can enhance situational awareness to deliver faster resolutions and minimize business disruption.